Immunopathogenesis of celiac disease.
The immunopathogenesis of celiac disease requires interactions between genetic, environmental and immunologic factors. Genes within the class II region of the major histocompatibility complex (HLA-D region) represent a major component contributing to disease susceptibility. Structural studies of genes within the HLA-D region have shown that the class II HLA haplotype associated with celiac disease is extended, and includes not only the HLA-DR and DQ subregions, but also the HLA-DP subregion. The celiac disease-associated haplotype is marked in the HLA-DP subregion by a polymorphic 4 kilobase Rsa I genomic fragment derived from a DP beta chain. Other studies suggest that, in addition to dietary gliadins, a viral protein may play a role in the pathogenesis of celiac disease, perhaps by virtue of immunologic cross reactivity between antigenic determinant shared by the viral protein and alpha gliadins.
Kagnoff
M F
MF
Department of Medicine, University of California, San Diego, La Jolla 92093.
D000917:Antibody Formation; D002446:Celiac Disease / Q000209:etiology* / Q000276:immunology; D004032:Diet / Q000009:adverse effects; D005819:Genetic Markers; D005903:Gliadin / Q000276:immunology; D006681:HLA-D Antigens / Q000235:genetics; D006801:Humans; D007111:Immunity, Cellular; D014764:Viral Proteins / Q000276:immunology
D005819:Genetic Markers; D006681:HLA-D Antigens; D014764:Viral Proteins; D005903:Gliadin