Those with Celiac disease carry the HLA-DQ2/8 genes that predispose them to Celiac but so do 30-40% of the general population and only a small number of those people develop CD. So what else might be factoring into the development of gluten intolerance / Celiac? Many scientists are now looking towards the gut microbiome.
What causes Celiac and is the microbiome part of that causality?
Celiac diseases is an autoimmune disease in which gluten consumption triggers an immune response from the small intestine. This immune response can, over time, damage the lining of the small intestine and hinder nutrient absorption. The damage can lead to symptoms such as fatigue, diarrhea, bloating, anemia and weight loss and other serious complications.
The damage in the small intestines is to tiny, hair-like villi that line the intestine wall. The job of villi is to absorb nutrients from food. When the villi are damaged by an immune reaction to gluten, the intestine loses its ability to absorb nutrients and the sufferer can become malnourished.
The immune reaction in those with Celiac occurs when the body mistake gliadin, a substance that is part of gluten, as an invasive attacker. It is not known why people develop this reaction but there are known risk factors for developing the condition.
Family history or genetic predisposition plays a role in the development of Celiac. Specifically the HLA-DQ genes. But they aren’t the sole cause, as many people carry the gene without developing Celiac.
Another known risk factor is early childhood digestive system infection. Or had early childhood exposure to antibiotics. There is also some evidence to support that introducing gluten into the diet before three months may increasing Celiac risk as well.
Research into the microbiomes of children living with Celiac show significant alterations in their microbial composition compared to controls. Though it is not clear whether this is a cause or consequence of the disease, it does provide important information about the connection and how that connection may be manipulated to better understand and treat CD.
The research specifically identified higher counts of Bacteroides in CD children versus controls. Some species of Bacteroides including B. vulgatus and B. fragilis have been shown to have pro-inflammatory effects. Low levels of bifidobacteria and lactobacilli were also a consistent finding in children with Celiac.
Though there have been microbial differences noted in those with Celiac, the exact mechanism by which those alterations are affecting the disease are largely unknown. Though some bacterial species from the Lactobacillus and Bifidobacterium genera have been shown to have protective properties from the damage caused by gliadin in those with CD. Epithelial cells that line the small intestine incur less damage with the presents of higher concentrations of Lactobacillus and Bifidobacterium.
Children who have reported early antibiotic use have been found to have a higher risk of developing CD. Antibiotic use is known to have detrimental effects on the microbiome and its development and can often onset long-term dysbiosis in the gut. This may be a clue that imbalance in the microbiome is playing a role in the onset of and function of Celiac disease, rather than it being the result of the disease.
Further research is first needed into the exact interplay between gut bacteria and the autoimmune reaction caused by the consumption of gluten. As of yet the disease is not well enough understood to advocate for any kind of treatment intervention. At this time the only viable treatment for Celiac is a gluten free diet. Though the microbiome connection may provide some clarity on the causality of Celiac and direct future treatments of the condition.
Further research is first needed into the exact interplay between gut bacteria and the autoimmune reaction caused by the consumption of gluten. As of yet the disease is not well enough understood to advocate for any kind of treatment intervention. At this time the only viable treatment for Celiac is a gluten free diet. Though the microbiome connection may provide some clarity on the causality of Celiac and direct future treatments of the condition.
Why Is Celiac Disease on the Rise? The Answer Is in The Gut Microbiome
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May 18, 2023
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