The pathogenesis of gluten-sensitive enteropathy.
Gluten-sensitive enteropathy is characterized by flattening of intestinal villi and malabsorption caused by the toxic effect of gluten, a wheat protein. Gluten activates an endogenous mechanism of toxicity that may be the local mucosal immune system: local mucosal immunoglobulin and antigluten antibody production occur soon after gluten ingestion. Approximately 80% of patients with this disease possess HL-A8, a second segregant series antigen. This association also occurs in dermatitis herpetiformis, a disease with vesicular skin lesions and gluten-sensitive flattening of intestinal villi. The association suggests that the fundamental abnormality in enteropathy is a binding reaction involving gluten protein and a binding site on a cell surface, determined in part by the histocompatibility gene; this reaction then results in a local mucosal immune response to gluten. Alternatively, the fundamental abnormality may be the presence of an abnormal immune-response gene linked to the HL-A8 gene or acting in concert with it; this immune-response gene results in local mucosal production of antigluten antibody.
D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D000818:Animals; D000918:Antibody Specificity; D001706:Biopsy; D002417:Cattle; D002446:Celiac Disease / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003470:Culture Media; D004847:Epithelial Cells; D004848:Epithelium / Q000201:enzymology; D005903:Gliadin / Q000506:poisoning; D005983:Glutens / Q000506:poisoning; D006680:HLA Antigens; D006801:Humans; D007079:Ileitis / Q000473:pathology; D007070:Immunoglobulin A / Q000096:biosynthesis; D007075:Immunoglobulin M / Q000096:biosynthesis; D007413:Intestinal Mucosa / Q000473:pathology; D007583:Jejunum / Q000201:enzymology / Q000473:pathology; D007930:Leucine / Q000378:metabolism; D008213:Lymphocyte Activation; D008297:Male; D009924:Organ Culture Techniques; D010455:Peptides / Q000506:poisoning; D013936:Thymidine / Q000378:metabolism
D003470:Culture Media; D006680:HLA Antigens; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D010455:Peptides; D005983:Glutens; D005903:Gliadin; D000469:Alkaline Phosphatase; D007930:Leucine; D013936:Thymidine