Celiac disease: should we care about microbes?

Area of Science:

• Immunology
• Microbiology
• Gastroenterology

Background:

• Celiac disease (CeD) prevalence is rising, indicating environmental factors beyond gluten are involved.
• Gastrointestinal infections are linked to increased CeD risk, but the underlying mechanisms are unclear.

Purpose of the Study:

• To review the evidence on the role of microbes in celiac disease pathogenesis.
• To explore specific microbial pathways that may contribute to immune activation and loss of tolerance in CeD.

Main Methods:

• Literature review of cohort studies and animal models investigating microbial roles in CeD.
• Analysis of proposed immune pathways triggered by viral and bacterial pathogens relevant to CeD.

Main Results:

• Animal models show opportunistic pathogens can induce immune activation relevant to CeD.
• The hypothesis that infections contribute to CeD pathogenesis in genetically susceptible individuals is supported.

Conclusions:

• Microbes, including viruses and bacteria, likely play a role in promoting CeD.
• Identifying microbial pathways is crucial for developing microbiota-modulating strategies for CeD prevention.