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Intestinal Barrier Function in Gluten-Related Disorders.

Danielle Cardoso-Silva1, Deborah Delbue2, Alice Itzlinger3

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|October 5, 2019
PubMed
Summary

Gluten-related disorders like celiac disease and non-celiac wheat sensitivity involve distinct immune responses and gut microbiota changes. Epithelial barrier dysfunction is a key factor in their development.

Keywords:
celiac diseaseepithelial barriernon-celiac gluten sensitivitynon-celiac wheat sensitivitypermeabilitywheat allergy

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Area of Science:

  • Gastroenterology
  • Immunology
  • Microbiology

Background:

  • Gluten-related disorders encompass celiac disease, wheat allergy, and non-celiac gluten/wheat sensitivity.
  • These conditions share a common trigger (wheat/cereals) but differ in their underlying pathophysiological mechanisms.
  • Epithelial barrier impairment is observed in all three, prompting investigation into its pathogenetic role.

Purpose of the Study:

  • To provide an overview of the small intestinal mucosal barrier.
  • To summarize epithelial barrier dysfunction in gluten-related disorders.
  • To review evidence supporting the epithelial barrier's role in celiac disease and non-celiac wheat sensitivity.

Main Methods:

  • Literature review of studies on gluten-related disorders and the small intestinal mucosal barrier.
  • Analysis of pathophysiological pathways in celiac disease, wheat allergy, and non-celiac wheat sensitivity.
  • Synthesis of data on epithelial barrier function and dysfunction.

Main Results:

  • Celiac disease involves T-cell mediated immunity; wheat allergy involves IgE or non-IgE responses.
  • Non-celiac wheat sensitivity is linked to innate immunity and gut microbiota, not adaptive immunity.
  • Epithelial barrier dysfunction is a common feature, potentially playing a primary role in celiac disease and non-celiac wheat sensitivity.

Conclusions:

  • Gluten-related disorders have distinct immunopathogenesis.
  • The epithelial barrier's role is crucial and warrants further investigation, particularly in celiac disease and non-celiac wheat sensitivity.
  • Understanding barrier dysfunction is key to managing these conditions.