PMID- 8817764
OWN - NLM
STAT- MEDLINE
DCOM- 19961209
LR  - 20171116
IS  - 1049-5118 (Print)
IS  - 1049-5118 (Linking)
VI  - 7
IP  - 3
DP  - 1996 Jul
TI  - The immunologic basis for celiac disease and related disorders.
PG  - 124-33
AB  - Celiac disease is the classical food-sensitive enteropathy and is caused by an 
      antigen-specific immunologic hypersensitivity response to gluten within the small 
      intestinal mucosa. Antibody and T-cell hypersensitivity may play a role in vivo, 
      but it is more likely that the primary problem is an inappropriate T-cell 
      response to gluten. The deleterious effects of gluten in celiac patients can be 
      completely explained by the immune-mediated alterations in upper small-intestinal 
      mucosal shape; these alterations include the replacement of long villi and short 
      crypts with short or absent villi and hyperplastic crypts. It is an extremely 
      unusual disease in that it is highly linked to human leukocyte antigen (HLA)-DQ2, 
      and CD4+ T-cell clones that recognize gluten in the context of DQ2 have been 
      isolated from celiac mucosa lamina propria. HLA-DQ2 is commonly used in Whites, 
      but the incidence of celiac disease varies greatly between different countries 
      and with time, without any obvious explanation. Celiac disease is also unusual in 
      that it has features of autoimmune disease. Patients with active disease have 
      immunoglobulin (Ig)A antibodies in endomysium, an uncharacterized extracellular 
      matrix protein, and the presence of these antibodies is very specific for this 
      condition. However, because celiac disease is more common in IgA-deficient 
      patients, the IgA antiendomysial antibodies are unlikely to be pathogenic.
FAU - Braegger, C P
AU  - Braegger CP
AD  - Gastroenterology Unit, Kinderspital, Zurich, Switzerland.
FAU - MacDonald, T T
AU  - MacDonald TT
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Gastrointest Dis
JT  - Seminars in gastrointestinal disease
JID - 9100391
RN  - 0 (CD4 Antigens)
SB  - IM
MH  - CD4 Antigens/analysis/*biosynthesis
MH  - CD4-Positive T-Lymphocytes/immunology/*metabolism
MH  - *Celiac Disease/diagnosis/diet therapy/immunology/physiopathology
MH  - Humans
RF  - 95
EDAT- 1996/07/01 00:00
MHDA- 1996/07/01 00:01
CRDT- 1996/07/01 00:00
PHST- 1996/07/01 00:00 [pubmed]
PHST- 1996/07/01 00:01 [medline]
PHST- 1996/07/01 00:00 [entrez]
PST - ppublish
SO  - Semin Gastrointest Dis. 1996 Jul;7(3):124-33.