title: Immune development and intestinal microbiota in celiac disease.
abstract: Celiac disease (CD) is an immune-mediated enteropathy, triggered by dietary wheat gluten and similar proteins of barley and rye in genetically susceptible individuals. The etiology of this disorder is complex, involving both environmental and genetic factors. The major genetic risk factor for CD is represented by HLA-DQ genes, which account for approximately 40% of the genetic risk; however, only a small percentage of carriers develop the disease. Gluten is the main environmental factor responsible for the signs and symptoms of the disease, but exposure to gluten does not fully explain the manifestation of CD. Epidemiological and clinical data suggest that environmental factors other than gluten might play a role in disease development, including early feeding practices (e.g., breast milk versus formula and duration of breastfeeding), infections, and alterations in the intestinal microbiota composition. Herein, we review what is known about the influence of dietary factors, exposure to infectious agents, and intestinal microbiota composition, particularly in early life, on the risk of developing CD, as well as the possible dietary strategies to induce or increase gluten tolerance.
authors.affiliation: Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition, Spanish National Research Council (ICTAN-CSIC), Calle José Antonio Novais, 10, 28040 Madrid, Spain.
authors.forename: Tamara
authors.initials: T
authors.lastname: Pozo-Rubio
authors.forename: Marta
authors.initials: M
authors.lastname: Olivares
authors.forename: Esther
authors.initials: E
authors.lastname: Nova
authors.forename: Giada
authors.initials: G
authors.lastname: De Palma
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Mujico
authors.forename: Maria Desamparados
authors.initials: MD
authors.lastname: Ferrer
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sanz
mesh_terms: D000818:Animals; D002446:Celiac Disease / Q000276:immunology* / Q000382:microbiology*; D004032:Diet; D005247:Feeding Behavior; D006801:Humans; D007422:Intestines / Q000276:immunology* / Q000382:microbiology*; D054892:Metagenome / Q000276:immunology*; D012307:Risk Factors