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Systemic autoimmune disorders in celiac disease

Fasano, Alessio

Current Opinion in Gastroenterology: November 2006 - Volume 22 - Issue 6 - p 674–679
doi: 10.1097/01.mog.0000245543.72537.9e
Immunology

Purpose of review Celiac disease is an immune-mediated disorder clinically characterized by a multitude of symptoms and complications. The comorbidity between celiac disease and other autoimmune disorders has been clearly established.

Recent findings Two main theories have been postulated to explain this comorbidity: (1) linkage disequilibrium between the genes responsible for celiac disease and those responsible for the coexpressed autoimmune diseases or (2) untreated celiac disease leading to the onset of other autoimmune diseases. This article reviews the current literature supporting either theory and places the current knowledge in the field within the context of the most recent data on the pathogenesis of celiac disease.

Summary The current literature did not clearly establish which of the two theories explain the comorbidity between celiac disease and other autoimmune disorders. There is, however, growing evidence that the loss of the intestinal barrier function typical of celiac disease could be responsible of the onset of other autoimmune disease. This concept implies that the autoimmune response can be theoretically stopped and perhaps reversed if the interplay between autoimmune predisposing genes and trigger(s) is prevented or eliminated by a prompt diagnosis and treatment.

Center for Celiac Research and Mucosal Biology Research Center and Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA

Correspondence to Alessio Fasano, MD, Mucosal Biology Research Center, University of Maryland School of Medicine, 20 Penn Street HSF II Building, Room S345, Baltimore, MD 21201, USA Tel: + 1 410 706 5501; e-mail: afasano@mbrc.umaryland.edu

© 2006 Lippincott Williams & Wilkins, Inc.