Gluten is a protein complex found in such foods as wheat barley and rye. There are several related disorders in which a person develops an allergy to gluten. Celiac disease, or gluten sensitive enteropathy, is a disorder in which gluten in the diet causes difficulty in absorbing nutrients and symptoms such as bloating, diarrhea, abdominal pain and many other possible non-gastrointestinal symptoms such as rashes. The exact cause is not known, but some contributing factors have been investigated.
The Trigger
Celiac disease and other gluten allergies would not exist without a trigger. In this disease, the trigger is known to be the gluten protein complex, as noted by "Robbins and Cotran Pathologic Basis of Disease" by Dr. Vinay Kumar. Without exposure to gluten, the allergy does not develop. However, there is more involved than simply exposure. Otherwise, everybody would be allergic to gluten.
Genes
An additional component is the genetic makeup of the person. Genes code for proteins, and different people have slightly different gene sequences and, as a result, different protein structures. Proteins have many roles in the body, such as forming support structures, like brick and mortar of a building, or they act as small machines that aid chemical reactions. How the genes and proteins interact with the environment, including the gluten complex and the immune system, is unknown. However, according to a 2009 article in "Gastroenterology," genes HLA-DQ2 or HLA-DQ8 must be present in order to develop the disease. These genes interact with the immune system.
Immune System
As noted by "Gastroenterology" and "Harrison's Principles of Internal Medicine" by Anthony S Fauci, M.D., the immune system makes antibodies against the protein tissue transglutaminase or TG2. Antibodies are proteins made by the immune system that normally attack invading organisms. The result is that when exposed to gluten, cells of the immune system attack the intestinal wall and provoke a general immune response that results in the symptoms of gluten allergy and celiac disease.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar; 2009
- "Gastroenterology"; Celiac Disease: From Pathogenesis to Novel Therapies"; D. Schuppan, Y. Junker, D. Barisani; December 2009
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci; 2008
