Immunology of celiac disease: New perspectives

Celiac disease is defined as a state of heightened immunological responsiveness to ingested gluten proteins in a genetically predisposed subjects. Tissue transglutaminase (TG) seems to play an important role in the pathogenesis of celiac disease. It is the antigen of endomysial antibodies, which are an important serological diagnostic feature in celiac disease. Furthermore, TG modifies gliadin through deamination and thereby enhances the immunogenicity of this protein. HLA-DQ positive macrophages are able to present gliadin more effectively and to ellicit an immune-response by gliadin specific T-cells. As a consequence mucosal lesions typical of celiac disease may develop.