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The Role of Gluten in Celiac Disease and Type 1 Diabetes - PubMed

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Review

The Role of Gluten in Celiac Disease and Type 1 Diabetes

Gloria Serena et al. Nutrients. 2015.

Abstract

Celiac disease (CD) and type 1 diabetes (T1D) are autoimmune conditions in which dietary gluten has been proven or suggested to play a pathogenic role. In CD; gluten is established as the instigator of autoimmunity; the autoimmune process is halted by removing gluten from the diet; which allows for resolution of celiac autoimmune enteropathy and subsequent normalization of serological markers of the disease. However; an analogous causative agent has not yet been identified for T1D. Nevertheless; the role of dietary gluten in development of T1D and the potentially beneficial effect of removing gluten from the diet of patients with T1D are still debated. In this review; we discuss the comorbid occurrence of CD and T1D and explore current evidences for the specific role of gluten in both conditions; specifically focusing on current evidence on the effect of gluten on the immune system and the gut microbiota.

Keywords: celiac disease; gluten; type 1 diabetes.

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Figures

Figure 1
Figure 1

Mechanisms by which ingested gluten triggers celiac disease: digested gluten interacts with epithelial cells in the small intestine and triggers the disruption of tight junctions (1). The consequent increased intestinal permeability leads to the translocation of gluten peptides to the lamina propria (2) where they induce the production of IL-15 (3). In the lamina propria, gluten peptides are modified by tissue transglutaminase enzymes (4) and trigger an adaptive immune response (5–8).

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