Conclusions Drawn from BMC Medicine Article
Conclusions Drawn from BMC Medicine Article, “Divergence of Gut Permeability and Mucosal Immune Gene Expression in Two Gluten-Associated Conditions: Celiac Disease and Gluten Sensitivity,” published on March 9, 2011
Many were interested in the blog posted by my colleague, Maeve Whelan-Wuest last Monday, March 21, 2011, so I have decided to follow up with more information regarding the conclusions made in the study.
The following conclusions were reported in the provisional article:
“The results of this study suggest that Celiac Disease (CD) and Gluten Sensitivity (GS) are distinct clinical entities caused by different intestinal mucosal responses to gluten. CD results from a complex, as yet undetermined, interplay of increased intestinal permeability, mucosal damage, environmental factors in addition to gluten, and genetic predisposition, which involves both MHC and non-MHC genes. The typical intestinal lesions in CD are thought to be mediated by both innate and adaptive immune effector pathways. Our findings suggest that, in a different way, GS is associated with prevalent activation of an innate immune response. Although the mechanisms responsible for the loss of intestinal barrier function in CD have been delineated in part, the factors responsible for the loss of gluten tolerance and the development of autoimmunity in this condition are still incompletely understood. We believe that this study could contribute to the clinical characterization of GS as a condition associated with prevalent gluten-induced activation of innate immunity in the absence of detectable changes in mucosal barrier function, and that it provides additional clues to the definition of the complex gluten-induced changes in TJ regulation and immune processes underlying CD pathogenesis. Double blind, placebo-controlled studies are necessary to further solidify the definition of GS patients and to search for specific biomarkers for a proper diagnosis.”
The significance of the study, according to lead author, Dr. Alessio Fasano, Medical Director of the University of Maryland’s Center for Celiac Research, is that “for the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease.”
For more information on Celiac Disease the following Celiac Associations may be of interest to you: