The Interaction Between Celiac Disease and Intestinal Microbiota

Journal of Clinical Gastroenterology - Tập 50 Số Supplement 2 - Trang S145-S147 - 2016
Giuseppe Losurdo1,2, Mariabeatrice Principi1, Andrea Iannone1, Enzo Ierardi1, Alfredo Di Leo1
1Department of Emergency and Organ Transplantation, Section of Gastroenterology, University "Aldo Moro" of Bari, Bari, Italy
2Giuseppe Losurdo, MD, Department of Emergency and Organ Transplantation, Section of Gastroenterology, University "Aldo Moro" of Bari, Piazza Giulio Cesare, Bari 70124, Italy (e-mail: [email protected]).

Tóm tắt

Celiac disease (CD) is the most common autoimmune enteropathy, triggered by a deregulated immune response to gliadin. It has been hypothesized that human intestinal microbiota may interfere with the pathogenesis of the disease and in the clinical course of CD. In the present review, we analyzed the microbiota alterations observed in the course of CD, how they may influence the pathogenesis of CD, and the possible applications for a microbiota modulation in CD. In detail, most of the current literature underlined that the dysbiosis in CD is hallmarked by an increase in gram-negative and Bacteroidetes species, and by a decrease in Bifidobacteria and Lactobacilli. As the intestinal microbiota is able to modulate the cytokine environment, an unfavorable microbiota could amplify the immune response to gliadin in individuals with CD, whereas the administration of probiotic species could lead to a decrease in proinflammatory cytokine production. Therefore, dysbiosis could represent an important trigger in CD pathogenesis, along with genetic (HLA—haplotypes) and environmental factors (antibiotic administration, mode of delivery, and breastfeeding). Although data on the modulation of microbiota by GFD are conflicting, current evidence has demonstrated that probiotic administration could be useful to improve symptoms and to reduce molecular mucosal inflammation, by downregulating the cytokines involved in CD pathogenesis. However, studies analyzing this aspect are few in number, thus stimulating the exploration of this field, with the aim of achieving a solid pathophysiological basis for probiotic administration in CD.

Từ khóa


Tài liệu tham khảo

Green, 2007, Celiac disease, N Engl J Med, 357, 1731, 10.1056/NEJMra071600

de Sousa Moraes, 2014, Intestinal microbiota and probiotics in celiac disease, Clin Microbiol Rev, 27, 482, 10.1128/CMR.00106-13

Pagliari, 2015, The interaction among microbiota, immunity, and genetic and dietary factors is the condicio sine qua non celiac disease can develop, J Immunol Res, 2015, 123653, 10.1155/2015/123653

Cenit, 2015, Intestinal microbiota and celiac disease: cause, consequence or co-evolution?, Nutrients, 7, 6900, 10.3390/nu7085314

Rostami Nejad, 2015, The role of infectious mediators and gut microbiome in the pathogenesis of celiac disease, Arch Iran Med, 18, 244

Cammarota, 2015, The involvement of gut microbiota in inflammatory bowel disease pathogenesis: potential for therapy, Pharmacol Ther, 149, 191, 10.1016/j.pharmthera.2014.12.006

Purchiaroni, 2013, The role of intestinal microbiota and the immune system, Eur Rev Med Pharmacol Sci, 17, 323

Di Cagno, 2011, Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization, BMC Microbiol, 11, 219, 10.1186/1471-2180-11-219

Golfetto, 2014, Lower bifidobacteria counts in adult patients with celiac disease on a gluten-free diet, Arq Gastroenterol, 51, 139, 10.1590/S0004-28032014000200013

Nadal, 2007, Imbalance in the composition of the duodenal microbiota of children with coeliac disease, J Med Microbiol, 56, 1669, 10.1099/jmm.0.47410-0

Cheng, 2013, Duodenal microbiota composition and mucosal homeostasis in pediatric celiac disease, BMC Gastroenterol, 13, 113, 10.1186/1471-230X-13-113

Francavilla, 2014, Salivary microbiota and metabolome associated with celiac disease, Appl Environ Microbiol, 80, 3416, 10.1128/AEM.00362-14

Papista, 2012, Gluten induces coeliac-like disease in sensitised mice involving IgA, CD71 and transglutaminase 2 interactions that are prevented by probiotics, Lab Invest, 92, 625, 10.1038/labinvest.2012.13

Laparra, 2012, Bifidobacterium longum CECT 7347 modulates immune responses in a gliadin-induced enteropathy animal model, PLoS One, 7, e30744, 10.1371/journal.pone.0030744

De Palma, 2012, Modulation of phenotypic and functional maturation of dendritic cells by intestinal bacteria and gliadin: relevance for celiac disease, J Leukoc Biol, 92, 1043, 10.1189/jlb.1111581

Olivares, 2015, The HLA-DQ2 genotype selects for early intestinal microbiota composition in infants at high risk of developing coeliac disease, Gut, 64, 406, 10.1136/gutjnl-2014-306931

Olivares, 2015, Human milk composition differs in healthy mothers and mothers with celiac disease, Eur J Nutr, 54, 119, 10.1007/s00394-014-0692-1

Palma, 2012, Influence of milk-feeding type and genetic risk of developing coeliac disease on intestinal microbiota of infants: the PROFICEL study, PLoS One, 7, e30791, 10.1371/journal.pone.0030791

Montenegro, 2014, Non steroidal anti-inflammatory drug induced damage on lower gastro-intestinal tract: is there an involvement of microbiota?, Curr Drug Saf, 9, 196, 10.2174/1574886309666140424143852

Mårild, 2013, Antibiotic exposure and the development of coeliac disease: a nationwide case-control study, BMC Gastroenterol, 13, 109, 10.1186/1471-230X-13-109

Decker, 2011, Cesarean delivery is associated with celiac disease but not inflammatory bowel disease in children, Gut Microbes, 2, 91, 10.4161/gmic.2.2.15414

Emilsson, 2015, Perinatal risk factors for development of celiac disease in children, based on the prospective Norwegian Mother and Child Cohort Study, Clin Gastroenterol Hepatol, 13, 921, 10.1016/j.cgh.2014.10.012

De Palma, 2009, Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects, Br J Nutr, 102, 1154, 10.1017/S0007114509371767

Sanz, 2010, Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans, Gut Microbes, 1, 135, 10.4161/gmic.1.3.11868

Wacklin, 2014, Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet, Am J Gastroenterol, 109, 1933, 10.1038/ajg.2014.355

Ianiro, 2014, Therapeutic modulation of gut microbiota: current clinical applications and future perspectives, Curr Drug Targets, 15, 762, 10.2174/1389450115666140606111402

Smecuol, 2013, Exploratory, randomized, double-blind, placebo-controlled study on the effects of Bifidobacterium infantis natren life start strain super strain in active celiac disease, J Clin Gastroenterol, 47, 139, 10.1097/MCG.0b013e31827759ac

Klemenak, 2015, Administration of Bifidobacterium breve decreases the production of TNF-α in children with celiac disease, Dig Dis Sci, 60, 3386, 10.1007/s10620-015-3769-7

Olivares, 2014, Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed coeliac disease, Br J Nutr, 112, 30, 10.1017/S0007114514000609