Gliadin-Specific T-Cells Mobilized in the Peripheral Blood of Coeliac Patients by Short Oral Gluten Challenge: Clinical Applications.

Celiac disease (CD) is a common lifelong food intolerance triggered by dietary gluten and affecting 1% of the general population. Gliadin-specific T-cell lines and T-cell clones obtained from intestinal biopsies have provided a great support to the investigation of immuno-pathogenesis of CD. In 2000 a new in vivo, less invasive, approach was established aimed to evaluate the adaptive gliadin-specific T-cell response using lymphocytes obtained from the peripheral blood of celiac patients on gluten free diet. In fact, the ingestion for three days of wheat-containing foods mobilizes memory gliadin-specific T lymphocytes from gut-associated lymphoid tissue in the peripheral blood of CD patients. Such antigen-specific T-cells can be transiently detected by using interferon-? ELISPOT assays or by flow cytometry tetramers technology. This paper discusses the suitability of this in vivo tool to investigate the repertoire of gluten pathogenic peptides, to support CD diagnosis and to assess the efficacy of novel therapeutic strategies. A systematic review of all potential applications of the short oral gluten challenge is provided.