Celiac Disease Flash Cards

Signal Transduction Pathway: Normal Nutrient Absorption

Our bodies use nutrients to grow, get energy and to maintain cells. Once our bodies break down nutrients, they cross from the intestine to the bloodstream. The small intestine absorbs nutrients and transfers them to the bloodstream.

In the immunological theory of the pathogenesis of coeliac disease, gluten, or a component, is viewed as the antigen responsible for the immune response. Distinct autoantibodies targeting members of the TG family (TG2, TG3 and TG6) are found deposited in small-bowel mucosa and in extraintestinal tissues affected by the disease

Serum autoantibodies against other self-antigens also emerge in untreated celiac disease patients. There is an abnormality of small intestinal mucosa manifested by contact with gluten or wheat. Celiac disease-specific antibodies are widely used as diagnostic aids. Gluten-induced small-bowel mucosal T-cell response is the cornerstone in the pathogenesis of the disorder,

It has been considered an uncommon gastrointestinal disorder affecting many children, but it has evolved to become a common systematic condition affecting people of all ages

Symptoms include malabsorption, chronic diarrhea, iron deficiency anemia, weight loss and short stature in children. There is no precise cause for celiac disease, but it occurs from an interaction between genes, eating foods with gluten or other environmental factors

What is Gluten?

The term "gluten" is a generic term for the storage proteins found in many grains. Storage proteins are not all the same. The "gluten" in wheat, barley, rye, contain particular amino acid sequences harmful to people with celiac disease.

Diagnosis

There are two major steps in diagnosing celiac disease. The first step is conducting blood tests for gluten autoantibodies. These are IgA based tests accurate only while on a gluten-containing diet

Treatment

There is no cure to celiac disease. The only treatment is to remove all gluten from your diet. No surgery or medication is required. Since the term "gluten" is rarely used on ingredient labels, it is imperative that a person on a gluten-free diet identify the typical places gluten hides

Even after the villi in the small intestine are described as being "back to normal," there remains the potential of some nutrients being absorbed at lower levels. Because of this, the monitoring physician may recommend a blood test analysis to learn if selected vitamins or nutrients are being absorbed at adequate levels. Supplements are not always required.

A lifestyle change takes patience and understanding. The support of loved ones and friends is an important part of treatment. The positive attitudes and growing understanding of those around each of us makes the dietary transition easier.

If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.

A small bowel biopsy to assess gut damage. For those with suspected dermatitis herpetiformis, skin biopsies will be taken of the skin near the lesion. This examines samples taken from the small intestine. If a person has celiac disease, the lining of the small intestine will appear atrophic and will have a "cracked earth" appearance

The small intestine consists of a series of three projections that increase the surface area of the intestine for better absorption. The first of these projections is called circular folds. The next section is made up of villi, which are finger-like projections, and the last section is microvilli

All three projections increase the surface area of the intestine, making nutrient absorption easier. The stomach breaks down food into individual nutrients. Once the food is broken down into small nutrient particles, the villi absorbs the particles with or without the use of energy

About

Celiac disease is an autoimmune disorder that occurs in response to dietary gluten that is present in wheat, rye and barley and is common in foods such as bread, pasta, cookies, and cakes

Immunology

Celiac disease is characterized by the the presence of transglutaminase (TG), 2 serum antibodies. It's associated with major histocompatibility complex class II genes and the alleles encoding the human leukocyte antigen molecules (HLA)-DQ2 and HLA-DQ8. Almost all patients with celiac disease carry these HLA alleles.

The antigen may be presented differently to the immune system by an abnormal cell membrane. Increased amounts of antigen may be absorbed due to increased membrane binding or permeability, either of which could be genetically determined.

Celiac disease may occur because the patients are immunologically hyporesponsive. The disease goes into remission when gluten is removed from the diet. This suggests that gluten is a major player in the pathogenesis of the disease.

Gluten is found in Breads, pastas, cookies are obvious grain products. Gluten is also "hidden" in many processed foods such as coating of frozen french fries., potatoes, soy sauce and rice cereal as malt.

Even many non-food items like cosmetics, and household cleansers may contain gluten. Any product that is made with WBRO or any of their derivatives will contain varying amounts of gluten.

When people with Celiac disease try to break down nutrients from gluten, the immune system launches an attack against the small intestine, damaging the lining of the intestine and inflammation of the villi. This causes fewer nutrients to be passed into the bloodstream

Eventually the body becomes malnourished no matter how much food is eaten, because the body can no longer absorb enough of the nutrients in the food. When people with celiac disease eat gluten, their body has an immune response that attacks the small intestine. This damages the villi and causes small and long projections that line the small intestine that prevents proper nutrient absorption

Incorrect Cell Signaling Pathway

However, people with Celiac disease have a shorter villi, which affects how they absorb certain nutrients, particularly those from gluten. If you have a damaged villi, you can't absorb a sufficient amount of nutrients from food, no matter how much you eat