Scientists have made a breakthrough that could lead to new treatment options for people with celiac disease. The team has identified how and where the gluten response begins, and specific cells play a bigger role than previously thought.
Like other autoimmune disorders, celiac disease occurs when the body mistakenly launches an immune response against a harmless molecule—in this case, the trigger is gluten, a protein found in many cereal grains. Consuming these foods leads to a host of unpleasant symptoms, and the only treatment is a strict diet.
To help find a better option, the researchers in the new study investigated how and where the gluten response actually begins. They studied mice and lab-grown mini-guts (called organoids) to see how different cells responded to the presence of gluten.
“This allowed us to narrow down the specific cause and effect and prove exactly whether and how the reaction occurred,” said Tohid Didar, corresponding author of the study.
It turns out that epithelial cells (those that line the inner lining of the upper intestine) respond to gluten by actively stimulating the release of CD4+ T cells. In turn, these helper cells trigger an overactive immune response felt as common celiac symptoms. It was generally thought that the response involved only immune cells, but epithelial cells were suspected to play a role. Now, the team says, this suspicion has been confirmed.
The team also uncovered another factor at play: Epithelial cells send stronger signals to immune cells. Pseudomonas aeruginosaIt is a pathogenic type of bacteria that is not normally a healthy part of the human microbiome.
The discovery could provide new targets for developing drugs that potentially treat or prevent celiac disease, the researchers say. Pseudomonas aeruginosa It can also help identify patients at highest risk of developing this disease.
“The only way we can treat celiac disease today is to completely eliminate gluten from the diet,” said Elena Verdu, corresponding author of the study. “This is difficult to do, and experts agree that a gluten-free diet is not enough.”
The research was published in the journal Gastroenterology.
Source: McMaster University