Celiac disease: a unique model for investigating broken tolerance in autoimmunity.
Hardy MY, Tye-Din JA
Clin Transl Immunology. Nov 2016
COMMENT: In this very interesting review the authors discuss many immunological aspects and dedicate a special part to the emerging link between environment, microbiome and anti-gluten immune response .
It is clear that environmental factors are very important for Celiac Disease (CD) and many of the implicated environmental factors may act by altering the composition of the microbiome. The authors write:
Dysbiosis or perturbations in the composition of resident commensal microbial communities away from those found in healthy individuals, are reported in a range of autoimmune and inflammatory diseases, including CD. The dysbiosis is characterised by an abundance of Proteobacteria and a decrease in Lactobacillus. Epidemiological data support an association between dysbiosis and increased risk of CD
And, among potential mechanisms, the authors mention:
Modifying Treg induction, epithelial cell stress and IEL activation, phenotypic and functional maturation of DCs and pro-inflammatory cytokine production, intestinal permeability, and the induction of CD4+ T-cell responses