CHAPTER 51 – Celiac Disease

Publisher Summary This chapter illustrates whether Celiac disease also called gluten-sensitive enteropathy or celiac sprue is an autoimmune disorder and to what extent components of celiac disease involved in the disease development. The highly disease-specific antibodies to the enzyme tissue transglutaminase (TG2) are particularly focussed. Celiac disease is most often categorized as a food hypersensitivity or intolerance disorder. The disease is precipitated in genetically susceptible individuals by the ingestion of wheat gluten and similar proteins of other cereals. Some historic findings have led to the current understanding of celiac disease as a chronic inflammatory disorder with autoimmune components is described. If the critical role of gluten were not known, celiac disease would likely have been considered as a classical autoimmune disease. Among the chronic inflammatory disorders with autoimmune components, celiac disease stands out as a particularly good model since the precipitating antigen is known and the affected organ—the small intestine—is easily accessed. Insight into the pathogenesis of this disorder is relevant for a large group of diseases for which the genetic and environmental components are poorly characterized.