Only 20% of people affected by celiac disease are aware that they have it, while the remaining 80% continue to ingest gluten through bread, pasta, and pastries. Gluten is a complex of proteins found in wheat, barley, and rye. It becomes dangerous only for those who are genetically predisposed to celiac disease, especially through genes linked to the immune system (DQ2 and DQ8), which are responsible for recognizing foreign elements. This triggers an excessive immune response that attacks the small intestine; such an immune response causes the intestinal villi to atrophy, transforming the intricate forest of tiny projections that allows us to absorb nutrients from food.
The damage is not limited to the intestine; inflammation of the intestinal mucosa in fact triggers a response that affects the entire body, sometimes giving rise to other autoimmune diseases such as diabetes (5–6% of diabetics are also celiac), anemia and iron deficiency, and increased transaminase levels. Therefore, gluten must be eliminated from the diet. Unfortunately, some consequences of gluten exposure may not be reversible, such as severe osteoporosis caused by untreated celiac disease. Doctors state, however, that the longer a child is breastfed, the lower the risk of developing celiac disease. Furthermore, by acting on a protein called zonulin, it is possible to close the “gates” of intestinal permeability and reduce the passage of gluten from the intestine into the bloodstream.
In 2011, the research group of the Celiac Center at the University of Chicago, coordinated by pediatrician and gastroenterologist Stefano Guandalini, published a study in Nature according to which the inflammatory reaction to gluten derives from the combination of a protein, interleukin 15, with retinoic acid, a derivative of vitamin A. Therefore, celiac patients should be prohibited from taking medications that contain retinoic acid. Dr. Bana Jabri, a researcher at the Chicago institute, won the Warren Prize for Excellence in Celiac Disease Research in 2010.
Another distinguished Italian scholar working in this field in the United States (University of Maryland, Baltimore) is Professor Carlo Catassi, who also teaches Pediatric Medicine at the Polytechnic University of the Marche.
(Article published in Il Venerdì di Repubblica, January 27, 2012).
