For some of us, biting into a croissant is tantamount to declaring war on our intestines. Wheat flour is not just an ingredient, but the sworn enemy of approximately 1% of the world's population. Until now, however, we did not know precisely the reaction to gluten, or rather: the exact point at which the first “contact” between gluten and the organism occurs in celiac disease.
As in a detective novel where the crime scene is finally discovered, an international team led byMcMaster University in Canada has identified the precise place where the reaction to gluten begins: the cells of the intestinal wall. They are not simply bystanders caught in the crossfire, but active agents that trigger the entire chain of autoimmune events.
The Devastating Impact of Celiac Disease
Celiac disease is not just a food intolerance: it is a life sentence. For those who suffer from it, even the smallest traces of gluten can unleash an immunological storm in the intestine. Imagine having to obsessively scrutinize every food label, fearing invisible contamination that could transform a meal into a nightmare of pain. Bloating, diarrhea, constipation, abdominal pain; the reaction to gluten is a “violent rebellion” of the body that leaves you exhausted.
The real problems, however, appear in the long term. Chronic inflammation damages the intestinal villi, those microscopic structures that increase the surface area of the intestines, allowing nutrients to be absorbed. It's as if someone were systematically destroying our body's filtering and absorption system. The consequences? A sad catalogue of problems ranging from anemia to osteoporosis, from growth retardation to neurological disorders.
The only therapy currently available is the total elimination of gluten from the diet. A solution that, let's face it, is easier said than done.
Reaction to gluten, genes and the role of HLA proteins
Being predisposed to celiac disease is fundamentally a question of genetics. About 90% of people with the condition have genes that code for a protein called HLA-DQ2.5. The remaining 10% have a close relative, HLA-DQ8.
These proteins have a crucial job in the immune system: they present fragments of potential invaders to defense cells, a bit like police officers showing sketches of wanted criminals. The problem? These “policemen” They have poor eyesight and easily confuse gluten fragments with normal body structures.
However, genetic predisposition alone is not enough. Many people with these genes never develop celiac disease. Something else has to happen, and that “something else” is what researchers have finally identified.
Reaction to gluten, the Canadian discovery
The importance of research published on Gastroenterology lies in having demonstrated that the cells lining the intestine (enterocytes) are not simply collateral victims of immune friendly fire. They are active accomplices.
The finding suggests that intestinal cells are not just passive bystanders suffering collateral damage in a misguided effort to rid the body of gluten. They are key agents, personally presenting a combination of gluten fragments broken down by intestinal bacteria and transporter enzymes to gluten-specific immune cells.
To demonstrate this, the team created living models of the intestine (organoids) using intestinal cells from genetically modified mice. These mice expressed the human genes for the protein HLA-DQ2.5, making it possible to closely observe their reactions to gluten.
“This allowed us to narrow down the specific cause and effect and demonstrate exactly whether and how the reaction occurs,” explains the biomedical engineer. Tohid Didar of McMasters.
New therapeutic hopes
Knowing the precise beginning of the chain of events that leads to the reaction to gluten opens the way to new therapeutic approaches. If until now we have focused on eliminating gluten from the diet (with all the difficulties that entails), now we can imagine treatments that stop the reaction at the source.
La Dr. Elena Verdu, gastroenterologist of the McMasters, he underlines it well:
“The only way we can treat celiac disease today is to completely eliminate gluten from the diet. This is difficult to do, and experts agree that a gluten-free diet is insufficient.”
Imagine a future where people with celiac disease can enjoy a pizza or a piece of cake without consequences. It is a concrete possibility thanks to this discovery that has finally shown us where it all begins: as in any respectable mystery, identifying the crime scene is the first step towards solving the case.
