Narrative review Coeliac disease: understanding a complex autoimmune disorder. Ann Int Med

Department of Neurology and Neuroscience, Cornell University, New York, New York 10021, USA.
Annals of internal medicine (Impact Factor: 16.1). 03/2005; 142(4):289-98. DOI: 10.7326/0003-4819-142-4-200502150-00011
Source: PubMed

ABSTRACT Celiac disease is a common autoimmune disorder that has genetic, environmental, and immunologic components. It is characterized by an immune response to ingested wheat gluten and related proteins of rye and barley that leads to inflammation, villous atrophy, and crypt hyperplasia in the intestine. The disease is closely associated with genes that code for human leukocyte antigens DQ2 and DQ8. Transglutaminase 2 appears to be an important component of the disease, both as a deamidating enzyme that can enhance the immunostimulatory effect of gluten and as a target autoantigen in the immune response. Sensitive and specific serologic tests, including those for anti-transglutaminase antibody, are facilitating fast and noninvasive screening for celiac disease. Thus, they are contributing to a more accurate estimate of the prevalence of the disease and its association with other disorders. Celiac disease is associated with increased rates of anemia, osteoporosis, cancer, neurologic deficits, and additional autoimmune disorders. A gluten-free diet is the mainstay of safe and effective treatment of celiac disease, although its effect on some of the extraintestinal manifestations of the disease remains to be determined.

    • "This special property of wheat flour makes it suitable for the production of various bakery products . Ingestion of wheat gluten and related proteins from barley and rye , however , has been identified to cause celiac disease in humans , an autoimmune disorder characterized by inflammation , villous atrophy , and crypt hyperplasia in the small intestine ( Alaedini and Green 2005 ) . Therefore , in the past decades much research attention has been paid to the development of high - quality gluten - free cereal products by replacing wheat , barley , and rye flour with other cereal flours ( e . "
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    ABSTRACT: Humans have a history of cultivating cereal crops and utilizing their grains to prepare various types of food for thousands of years. The most popular cereal products available in the market include bread, cookies/biscuits, cakes, pasta, noodles, and extruded snacks and breakfast cereals. They are an important part of our daily diets and provide energy and essential nutrients for human health. Cereal grains contain starch and protein as the major components and lipid, non-starch carbohydrates, phytic acid, vitamins, and minerals as the minor components. Physical interactions and chemical reactions occur between these constituents during the processing and storage of cereal products, which determine their quality, storage stability, and nutritional value. With an increasing population of people suffering from celiac disease, diabetes, obesity, and other metabolic syndrome, there are opportunities and challenges for the food industry to develop healthier cereal products through utilizing novel ingredients and improving processing technologies. This book chapter offers a good review of chemical compositions of different cereal grains, processing technologies applied to produce various cereal foods, and future trends of research and product development in this area.
    Handbook of Food Chemistry, Edited by Peter Chi Keung Cheung, Bhavbhuti M. Mehta, 01/2015: chapter Chemical Composition of Cereals and Their Products; Springer-Verlag Berlin Heidelberg., ISBN: 978-3-642-36604-8
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    • "While some patients with cerebellar ataxia are reported to have low vitamin E levels, neurological manifestations may even arise without enteropathy [16] [17]. Consequently, immune mechanisms, as opposed to malabsorption, are suspected to be involved in the pathogenesis of these disorders [7]. This hypothesis is supported by evidence of lymphocytic infiltration in the central and peripheral nervous systems [18], as well as by the presence of serum antineuronal antibodies [19], in CD patients with neurological complications. "
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    ABSTRACT: Although a range of neurological and psychiatric disorders are widely reported to be associated with coeliac patients, their pathogenesis remains unclear. Some such disorders are believed to be secondary to vitamin deficiency due to malabsorption, others to immune mechanisms. We hypothesise that hyperhomocysteinemia might, by damaging the blood-brain barrier, expose neuronal tissue to all neuro-irritative metabolites, such as homocysteine itself, a neurotoxic excitatory and proconvulsant amino acid. Neurons respond to these stimuli through hyperexcitability, thereby predisposing subjects to neurological disorders such as epilepsy and headache. Furthermore, persisting endothelial damage may cause blood extravasation and subsequent deposition of calcium salts. We suggest that this might be the pathogenesis of the CEC syndrome, which is characterized by the association of coeliac disease, epilepsy and cerebral calcifications. Indeed, homocysteine plays a well-known role in cardiovascular endothelial dysfunction, with high serum and cerebrospinal fluid levels often being reported in coeliac patients. Moreover, data in the literature show a strong, growing association of homocysteine with epilepsy and migraine in non-coeliac subjects.
    Medical Hypotheses 07/2013; 81(4). DOI:10.1016/j.mehy.2013.06.025 · 1.07 Impact Factor
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    • "Celiac disease (CD) is one of the most common forms of food intolerance in the Western world, with an estimated prevalence of about 0.3–1% [1]. It occurs in genetically predisposed individuals upon ingestion of gluten, which can be found in grains such as wheat, barley and rye. "
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    ABSTRACT: Celiac disease (CD) is a chronic inflammatory disease of the small bowel that occurs with the ingestion of gluten, found in several grains products. Although HLA-DQ2 variant is required for the gluten-derived peptide gliadin presentation by antigen-presenting cells to T-cells, non-HLA genetic factors account for the majority of heritable risk. Several genome-wide association studies have identified susceptibility loci for CD on chromosome 1. Cells of the immune system express the cannabinoid receptor type 2 (CB2), a plasma-membrane receptor activated by both endogenous and exogenous cannabinoids. Consistent data evidence that CB2 is linked to a variety of immune functional events and that, in the course of an inflammatory process, an increased number of receptors becomes available for activation. The cannabinoid receptor type 2 gene (CNR2; GeneID1269) maps on 1p36.11. In order to investigate the possible involvement of CB2 in CD establishment, immunohistochemistry toward CB2 receptor and CD4+ cells in small bowel biopsies from celiac children and association analysis, through TaqMan assay, of a CNR2 common missense variant, rs35761398 (CAA/CGG), resulting in the aminoacidic substitution of Glutamine at codon 63 with Arginine (Q63R), in a cohort of 327 South Italian children have been performed. We observed in this study that CB2 is up-regulated in CD small bowel biopsies and CNR2 rs35761398 is significantly associated with CD (χ(2) = 37.064; d.f. 1; p = 1.14 × 10(-9)). Our findings suggest a role of CB2 in CD. The Q63R variant, increasing more than six-fold the risk for CD susceptibility, might eventually represent a novel molecular biomarker for CD risk stratification. Indeed, we provide here further evidence that CB2 receptor plays a critical role in autoimmunity susceptibility and indicates that it represents a molecular target to pharmacologically modulate the immune components in CD.
    Pharmacological Research 03/2012; 66(1):88-94. DOI:10.1016/j.phrs.2012.03.011 · 3.98 Impact Factor
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