Celiac disease: molecular basis

Coeliac disease (CD) is an inflammatory and multifactorial disorder triggered by cereal gluten in genetically predisposed individuals. CD has several clinical and histological forms characterized by different grade of small intestinal inflammation. Several studies have demonstrated the key role of adaptive CD4+ T lymphocytes in gluten dependent enteropathy, although it has been clear that the intraepithelial CD8+ T lymphocytes of innate immunity, highly infiltrating CD mucosa, are pivotal in the induction of intestinal mucosa alteration and malfunction. Recent evidences also highlighted how adaptive CD8+ T lymphocytes restricted by HLA class I molecules contribute to the enterocytes damage through a TCR dependent cytotoxic activity. The recent findings on the involvement of HLA class I genes in CD susceptibility are also discussed.