Celiac Sprue Causes

Celiac sprue results from a combination of immunological responses to an environmental factor (gluten) and genetic factors. People need both a genetic predisposition and the exposure to gluten in order to develop celiac sprue.

• Immune mechanisms
  
  
  • The interaction of gliadin (a specific gluten present in certain grain products) with the lining of the small intestine is critical in the development of celiac sprue. When people with celiac sprue eat foods containing gluten, gliadin is identified by the immune system as a threat. As a result, the body produces antibodies called antigliadin antibodies. Antigliadin antibodies are directed against gliadin.
    
    
  • Two additional antibodies have been identified in the bloodstream of people with celiac disease. In contrast to antigliadin antibodies, these antibodies target the person's own body and are referred to as autoantibodies (antibodies against our own cells and organs). The first antibody targets endomysium, a small intestinal smooth muscle component. The second antibody targets an enzyme called tissue transglutaminase. The presence of these autoantibodies suggests that autoimmunity plays a role in the disease process of celiac sprue.
  
  
• Genetic factors: Genes play an important role in celiac sprue. Celiac disease occurs much more frequently in relatives of persons with celiac sprue than in the general population. Celiac disease may occur in up to 10% of close family members of persons with celiac sprue.