Date Published: 15 October 2012

Latest research and insights into coeliac disease

Research scientists have recently visualised an interaction between gluten and T-cells of the immune system for the first time. This provides important insight into how coeliac disease is triggered.

Coeliac disease is an increasingly common (affecting an estimated 1 in 133 people) chronic inflammatory disorder that affects the digestive process of the small intestine. When a person with coeliac disease consumes gluten, their immune system triggers T-cells (which are a type of lymphocyte) to fight the offending proteins, which unfortunately damages the small intestine and inhibits absorption of important nutrients into the body. There are currently no treatments available apart from a diet completely free of gluten.

The researchers used the Australian Synchrotron to visually determine how T-cells of the immune system interact with gluten, a protein found in wheat, rye and barley, which causes coeliac disease, The discovery contributes to efforts to produce a treatment that would enable sufferers of coeliac disease to resume a normal diet.

It has been estimated that approximately half the population may be genetically susceptible to coeliac disease because they carry the immune response genes HLA-DQ2 or HLA-DQ8. At least one in 20 people who carry HLA-DQ2 and about one in 150 who have HLA-DQ8 develop coeliac disease, but people with other versions of the HLA-DQ genes are protected.

This has led researchers to consider how the immune system detects gluten.

" This is the first time that the intricacies of the interaction between gluten and two proteins that initiate immune responses have been visualised at a sub-molecular level," said Dr Reid, senior research fellow at Monash University, Melbourne.

This insight into a central event in coeliac disease will assist efforts to develop a blood test and a therapeutic vaccine for patients with coeliac disease who carry the gene HLA-DQ2. It is intended to restore immune tolerance to gluten and allow patients to return to again include gluten in their diet.

Future studies will investigate whether T-cell activation by gluten in patients with HLA-DQ2 follows similar principles as observed in this study that focused on HLA-DQ8-mediated coeliac disease.

Dr Bob Anderson said the research presented a unique opportunity.

" Because we now know the gluten peptides responsible for coeliac disease, we can interrogate the molecular events leading to a self-destructive immune response," he explained.

This recent discovery was led by Dr Hugh Reid and Prof Jamie Rossjohn of Monash University, Professor Frits Koning of Leiden University in the Netherlands and Dr Bob Anderson of biotechnology company ImmusanT Inc, based in the United States. The research was supported by an Australian Research Council Linkage grant and published in the scientific journal "Immunity".

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