People with celiac disease must avoid gluten, a protein in wheat, rye, and barley, as it can cause painful gut symptoms, hinder nutrient absorption, and lead to serious health issues. There’s no cure for this autoimmune disorder, affecting about 1% of the population, with cases doubling in the last 25 years.
A research team from McMaster University and international colleagues have spent six years studying where the gluten response begins. Previously, it was believed that the reaction occurred only in the gut wall and involved immune cells. However, a new study published in Gastroenterology reveals more to the story.
The researchers discovered that the inner lining of the upper intestine, known as the epithelium, which includes cells not typically part of the immune system, also helps drive the inflammatory response to gluten.
They created a lab model of this epithelium using microscopic biomaterials, which allowed them to study how specific molecules in these cells react to gluten. This model lets them observe how molecules alert immune cells to gluten and confirm that the epithelium is vital in triggering the immune response in celiac disease.
The study confirmed a previously unproven mechanism that could help develop new drugs for celiac disease. Currently, the only treatment is a strict gluten-free diet, which is challenging and often needs to be more. Identifying the source of the immune response might lead to drug research targeting this process.
The study also found that the epithelium sends stronger signals to immune cells when pathogens are present, suggesting future ways to prevent the disease by detecting pathogens early. The research was funded by Canadian health and research grants.
Journal reference:
- Sara Rahmani, Heather J. Galipeau et al. Gluten-Dependent Activation of CD4+ T Cells by MHC Class II–Expressing Epithelium. Gastroenterology. DOI: 10.1053/j.gastro.2024.07.008.