Coeliac disease – from genetic and immunological studies to clinical applications

Abstract

Coeliac disease is a common and important gastrointestinal disease. It affects at least 1%, most Western European populations and in Nordic countries it is even more frequent. It is strongly associated with certain Human Leukocyte Antigen-DQ genes and triggered by ingestion of wheat gluten and related cereals from rye and barley. The diagnosis relies on a combination of clinical signs, serology and small intestinal biopsy. Work during the last couple of decades has shown that gluten-specific, Human Leukocyte Antigen-DQ-restricted T-cells in the intestinal mucosa are of paramount importance in the disease process. The gluten peptides are chemically modified by the endogenous enzyme transglutaminase 2, the same enzyme that serves as target in today’s sensitive serological tests for coeliac disease. The increasing knowledge on the disease process allows for development of improved diagnosis, patient care and new treatment modalities.

Key Words:

• coeliac-disease
• gastroduodenal-basic
• gastroduodenal-clinical
• immunology
• small-intestinal-disorders

Acknowledgements

Work in the authors’ laboratory is supported by the Research Council of Norway through its Centres of Excellence funding scheme, project number 179573/V40, European Research Council advanced grant (FP/2007–2013/ERC grant 2010-268541), South-Eastern Norway Regional Health Authority and the Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds. The authors have scientific and financial collaboration with ImmusanT and Regeneron Inc. We are grateful to all the CD patients who willingly donate biopsies and other biological material to research and to colleagues and co-workers for their invaluable support.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.