Celiac Disease

Introduction:

Many celebrities and influencers often go on gluten-free diets. They say this is good for their health and will help them lose weight. But some individuals are on a gluten-free diet for completely different reasons. Some individuals physically cannot ingest gluten and will never be able to without damaging their intestines, unless a cure is found. Celiac disease has been correlated to many other autoimmune diseases, and a cure for celiac disease could help us learn more about these diseases and cure them, too. What is celiac disease, and how might it one day be cured?

Gluten and Celiac Disease:

Celiac disease is an autoimmune disease that damages the small intestine when gluten is ingested. Gluten, a protein found in wheat, barley, oats, and rye, is elastic and binds flour together in bread products. Approximately 1% of the population is unable to ingest gluten due to celiac disease, with an additional 5% of the population having non-celiac gluten intolerance (Mandelbaum, n.d.). Of the 1% of individuals with celiac disease, approximately 30% are undiagnosed. When individuals with celiac disease ingest even a crumb of gluten, the body attacks their small intestine and flattens their villi, small projections that line the small intestine and help with nutrient absorption, making it difficult for their body to absorb nutrients until the individual stops eating gluten (Celiac Disease Foundation, n.d.). Celiac disease was discovered in 1944 in the Netherlands by Dutch pediatrician Willem-Karel Dicke during the Hunger Winter, when there was a shortage of food, including wheat. Individuals with celiac disease were no longer ingesting gluten, so while many individuals lost weight, individuals with celiac disease could absorb nutrients and gained weight (Adler, 2019).

How Celiac Disease Works:

Celiac disease only occurs when the individual with celiac disease ingests glutenWhen gluten is ingested, it attaches itself to human leukocyte antigens, which are proteins in the body that bind with gluten in the small intestine (HLA). Before the gluten attaches to HLA, it goes through a process called deamidation, where an enzyme called transglutaminase 2 (TG2) alters the structure of the gluten. However, in individuals with celiac disease, deamidation makes the gluten more harmful (Celiac Disease Foundation, 2024). This is because deamidation enhances the stimulation of cells that secrete inflammatory substances, which inflame the small intestine (Schuppan et al., 2021). When the gluten reaches the small intestine, the body attacks the villi, making absorption of nutrients impossible. Celiac disease can develop if you have gene variants HLA-DQ2 or HLA-DQ8, which about 30% of individuals have. However, not everyone with these genes develops celiac disease (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.).

Other Side-effects:

While the main side-effects of ingesting gluten if you have celiac are disrupted bowel movement and abdominal pain, it has been found that celiac disease can also affect mental health. In fact, many individuals with celiac disease have reported mental health issues before being diagnosed. These conditions include anxiety, depression, schizophrenia, eating disorders, and brain fog, which is also known as gluten-induced neurocognitive impairment. Brain fog is commonly associated with fatigue and is a common complaint of individuals who are exposed to gluten (Mowbray, 2024). It has also been noted that individuals with untreated celiac disease commonly have another autoimmune disease, such as dermatitis herpetiformis, which is an itchy skin rash, type 1 diabetes, where the body can’t produce insulin to regulate blood sugar, and anemia, a condition where the body doesn’t have enough healthy red blood cells. Celiac disease has also been linked to infertility, but the true cause of most of these diseases is unknown, which is why understanding celiac disease could help us learn more about these diseases. The chance of developing another autoimmune disease is significantly lower if you are diagnosed with celiac disease at a younger age, as discovered in a 1999 study. Individuals diagnosed between the ages of 2-4 have a 10.5% chance of developing another autoimmune disease, whereas individuals diagnosed between the ages of 4-12 have a 16.7% chance of developing another autoimmune disease (Celiac Disease Foundation, n.d.).

Possible Cures:

Many studies have been performed in hopes of curing celiac disease or making a gluten-free diet easier. ZED1227, a new drug developed in Finland, deactivates the TG2 in your body, allowing gluten to go through the digestive system of a person with celiac disease without causing as much harm. While this may not allow individuals with celiac disease to ingest large amounts of gluten, if they accidentally ingested a small amount of gluten, they would not have a serious reaction to it (Celiac Disease Foundation, 2024). In another experiment in Italy, scientists placed gluten-hungry bacteria in a piece of wheat bread, stripping the bread of its gluten while keeping the bread. These bacteria are known as lactobacteria and are similar to the bacteria that are found in sourdough. However, it has not been proven that it is safe for individuals with celiac disease to eat, as with most cures for celiac disease, so these experiments are still works in progress (Mandelbaum, n.d.).

Conclusion:

Celiac disease is an autoimmune disease that causes the immune system to attack the small intestine’s villi when gluten, a protein found in many grains, is ingested. While only around 1% of the world’s population has celiac disease, understanding celiac disease can help us understand autoimmune diseases as a whole and how they are related, as a correlation between celiac disease and other autoimmune diseases has been noted. Extensive work to learn about celiac can teach us more about these other diseases and where they come from, as well as how they can be cured.

References:

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     https://www.popsci.com/what-is-gluten/

What is celiac disease? (n.d.). Celiac Disease Foundation. https://celiac.org/about-celiac-disease/ 

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Adler, D. G. (2019, April 22). The grim origins of 'gluten-free'. Discover Magazine. 

     https://www.discovermagazine.com/the-grim-origins-of-gluten-free-14914

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     (2021, June 30). A randomized trial of a transglutaminase 2 inhibitor for celiac disease. New 

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New hope for celiac disease: Promising drug shows progress in clinical trials. (2024, July 24). 

     Celiac Disease Foundation. https://celiac.org/2024/07/24/maki-trial-2024/ 

Symptoms and causes of celiac disease. (n.d.). National Institute of Diabetes and Digestive and 

     Kidney Diseases. Retrieved October, 2020, from https://www.niddk.nih.gov/health-information/ 

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Mowbray, S. (2024, August 20). Mental health issues and celiac disease are linked – A gluten-free 

     diet can help. Discover Magazine. https://www.discovermagazine.com/ 

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