According to the Canadian Celiac Association (CCA), the pathogenesis—that is the cause and development—of celiac disease consists of three factors: “genetic, environment and immunologic.”
With regard to genetics, the CCA points out that more than 97% of celiac patients have the genetic markers HLA DQ2 and/or HLA DQ8. Celiac disease is now known to be a hereditary disease. The CCA tells us that “first-degree and to a lesser extent second-degree relatives are at higher risk of having unrecognized celiac disease.”
Next, is the environmental “trigger,” as Dr. Alessio Fasano, professor of pediatrics, medicine and physiology at the Center for Celiac Research at the University of Maryland School of Medicine, calls it. This is gluten, a protein found in wheat, barley, and rye.
According to the Canadian Celiac Association, sometimes severe physical stressors can also trigger the immunologic reaction to gluten that is characteristic to celiac disease. Such sources of stress include pregnancy, infection, surgery, or even severe emotional stress.
In his article, “Surprises from Celiac Disease,” published in Scientific American, Dr. Fasano describes a different triad of factors involved in the pathogenesis of the disease. The first two factors are the ‘’trigger” of gluten, which sets off the immune response, and the genetic predisposition, as previously described. Fasano proposes that “other genes are likely to be involved as well, but these additional culprits may differ from person to person.”
The third factor, according to Fasano’s research is an “unusually permeable gut.” Fasano’s research regarding this third factor of pathogenesis offers hope of new prevention and treatment methods. He says, “Treatments that reduced leakiness could potentially ease not only celiac disease but also other autoimmune disorders involving unusually permeable intestines.”
This research into the leaky gut of celiacs can explain a question that has been perplexing researchers regarding the disease’s pathogenesis: Why do some people not develop celiac disease until later in life? According to Dr. Fasano, this issue could be associated with the microbes in the digestive tract. Should this prove true, we may be able to prevent or treat celiac disease with probiotics.
Miranda Jade Turbin
From our home to yours, Miranda Jade.