[Immunological mechanisms of celiac disease]

Celiac disease results from genetic abnormal immune response to gluten. This leads to local activation of immune system. There are several clinical manifestations of the disease (e.g. active, silent and latent). Fundamental processes of celiac disease occur in small intestine mucosa. As a result of immunological reactions the development of inflammatory process with typical histopathological lesions is observed. In pathogenesis of celiac disease immunological cellular response with significant role of T lymphocytes is of great importance. According to one hypothesis in the disease non proliferative activation of lamina propria CD4+ lymphocytes and proliferative activation of intra-epithelial TcR alpha/beta CD8+ and TcR gamma/delta lymphocytes is postulated. Probably in immunological reaction to gluten besides T lymphocytes other cells are involved (lymphocytes B, NK cells, neutrophils, eosinophils, macrophages, mastocytes) but their role was not clearly established. Recently in pathogenesis of celiac disease participation of cytokines produced locally in small intestine is often emphasized.