Description:
<jats:title>Summary</jats:title><jats:sec><jats:label /><jats:p>Evidence is accumulating which indicates that immune reactions to gliadins are involved in the pathogenesis of celiac disease, as humoral‐ and cell‐mediated immune responses to gliadins have been demonstrated in the jejunal mucosa and the peripheral blood of patients. An abnormal specific immunological response to gliadins is demonstrated not only in celiac children but also in their first‐degree relatives. Seventy‐eight percent of celiac patients, and 67, 87, and 100% of their fathers, siblings, and mothers, respectively, have a peripheral blood lymphocyte population reacting <jats:italic>in vitro</jats:italic> with a proliferation response to at least one of four peptide mixtures obtained from bread and durum wheat gliadins using a procedure simulating <jats:italic>in vivo</jats:italic> protein digestion. The specificity of this immunological hyperresponsiveness against wheat gliadins is shown by two sets of data: (a) Lymphocytes from celiac children and their relatives were much less sensitive to peptides from rice prolamin and not at all sensitive to peptides from wheat albumins. (b) Only 7% of 30 adult controls had a proliferative response of their peripheral lymphocytes to wheat gliadin peptides. It is not known at this time if healthy relatives of celiac patients mount an immune response against the intestine <jats:italic>in vivo</jats:italic>. However, it is possible that the presence of lymphocytes reactive to wheat gliadin peptides in apparently healthy relatives of celiac patients may explain why these relatives develop histologic evidence of celiac disease when their gluten intake is increased (Doherty M. Barry RF. <jats:italic>Lancet</jats:italic> 1981:1:517–20).</jats:p></jats:sec>