If they eat any foods that contain gluten, people who have gluten allergies can contract celiac disease, which can heavily damage the health of their gastrointestinal systems. To prevent these reactions, people with those allergies often need to adhere to strict gluten-free diets, which can be difficult to do and may not be entirely effective at preventing the symptoms of the disease.
Earlier this month, researchers at McMaster University in Hamilton, Ontario, Canada discovered what triggers the body’s immune reaction to gluten that results in celiac disease. Specifically, the upper intestine’s epithelial cells alert the immune system to the presence of gluten and then release certain cells that attack both the gluten and the body’s harmless cells indiscriminately. This discovery opens a range of new pathways towards treating and curing celiac disease.
What Celiac Disease Is
Affecting about 1% of people worldwide, celiac disease is a chronic autoimmune disorder triggered by gluten, a protein found in wheat, barley, and rye. When a person with a gluten allergy eats food that contains the protein, such as bread, pasta, or baked goods, the presence of gluten in their intestines causes the immune system to target and attack harmless molecules in their bodies.
Celiac disease can cause many severe symptoms in a person’s body, including nausea, fatigue, abdominal pain, bloating, gas, constipation, diarrhea, vomiting, and weight loss. People who have the disease may also exhibit symptoms like anemia, osteoporosis, mouth ulcers, joint pain, and itchy, blistery skin rashes.
Over time, celiac disease damages the lining of the small intestine and results in malabsorption, the inability for the organ to absorb nutrients. Especially in children, this failure to absorb nutrients can lead to irritability, restricted growth, delayed puberty, and neurological symptoms like ADHD, learning disabilities, and seizures.
How Researchers Found the Disease’s Trigger
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In their paper published in the journal Gastroenterology, the research team at McMaster University explains how they investigated the relationship between two human leukocyte antigen (HLA) proteins, known as HLA-DQ2.5 and HLA-DQ8, and the epithelial cells on the inside of the upper intestine. Present in the genes of people who have celiac disease, the proteins capture indigestible gluten peptides and encourage the body’s immune system to attack and destroy those peptides. The epithelial cells, meanwhile, receive most of the damage when celiac disease causes the body to attack itself.
To isolate and examine the precise trigger for the immune response that causes celiac disease, the research team constructed an organoid, or a functional living model of the gut, out of intestinal cells from lab mice. They then subjected the organoid to inflammatory triggers and predigested and intact gluten to see how the cells reacted.
The researchers discovered that the epithelial cells alerted the body’s immune system to the presence of gluten and released CD4+ T helper cells to start attacking the gluten; the epithelial cells amped up their signals when pathogens were present. Unfortunately, the CD4+ T cells can’t always distinguish between the harmful gluten and harmless molecules in the intestine; this causes them to also attack the lining of both intestines and produce symptoms of celiac disease.
How This Discovery Could Change Treatment
Though there’s currently no definitive cure or treatment for celiac disease, people who have it can reduce its symptoms and enable their intestines to heal by adopting a diet that cuts out all foods that contain gluten. There are some difficulties about adopting a gluten-free diet, though: for one, they’re very restrictive and don’t allow much deviation; for another, certain diets may not be as gluten-free as claimed and can still result in instances where a person experiences many of the disease’s symptoms. The caveats in adapting to gluten-free diets make the discovery of celiac disease’s trigger welcome.
Since the researchers have pinpointed the specific cells that trigger the immune reaction to gluten, scientists researching potential cures for the disease can now focus on finding a way to stop the epithelial cells from triggering this reaction and accidentally attacking harmless cells as well. According McMaster University professor of gastroenterology Elena Verdu, one of the study’s researchers, one potential method to preventing this triggering could be to deliver drugs already being tested in clinical trials to inhibit the epithelial cells’ response to gluten and prevent someone from developing celiac disease.
Final Thoughts
Triggered by the presence of gluten in the intestines, celiac disease can seriously impact the health of people who have gluten allergies. To avoid symptoms like fatigue, vomiting, diarrhea, or malnutrition, people with celiac disease often have to adapt to strict gluten-free diets that don’t always prove effective at completely eliminating symptoms. That’s why this recent discovery of the source of the body’s gluten response comes as such welcome news.
By showing that the upper intestine’s epithelial cells prompt the body’s immune cells to attack glutens that enter the intestine and inadvertently cause the symptoms of celiac disease, these scientists have identified a new path for discovering treatments and cures for this autoimmune disorder. While cures for this disease are likely still a long way off, this discovery prompts hope for eventually easing some of the difficulties that people who have gluten allergies face.
Disclaimer: This article is intended simply to provide information. It does not replace the medical advice of a physician. Please speak with your doctor if you have any questions or concerns.
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