What causes celiac sprue?

Answer 1

This is a long answer, be prepared...

Celiac Sprue (also called gluten-sensitive enteropathy and nontropical sprue) was described by Sam Gee in the late 1800s, but the cause of the problem (mainly relapsing diarrhea) was not determined to be related to the consumption of bread and cereals until the early-mid 1900s by the Dutch pediatrician Willem K Dicke. Dicke went on to determine through controlled experiments that Wheat, barley, rye, and (to a minor degree) oats triggered malabsorption, which could be reversed after exclusion of these "toxic" cereals from the diet, and, shortly after, the toxic agents were found to be present in gluten, the alcohol-soluble fraction of wheat protein. The celiac lesion in the proximal small intestine was first described in 1954. The primary findings were mucosal inflammation, crypt hyperplasia, and villous atrophy of the small intestinal wall.

In terms of genetics, it has been found that there are frequently many cases within families, and this fact has led geneticists to find a remarkably close association with the HLA-DQ2 and/or DQ8 gene locus to celiac disease which provides the basis of our current understanding of celiac sprue as an immune disorder that is triggered by an environmental agent (the gliadin component of gluten) in genetically predisposed individuals.

In the blood itself, tests can be run looking for antibodies against both gliadin and endomysium (a structure of the smooth muscle connective tissue). If these are present, it points toward a diagnosis of celiac disease quite nicely. More specifically, the antibody with the endomysium is to something called tissue transglutaminase.

Tissue transglutaminase is an intracellular enzyme that is released by inflammatory and endothelial cells and fibroblasts in response to mechanical irritation or inflammation. Once it has been secreted, it crosslinks glutamine-rich proteins such as gluten proteins from wheat. However, it can also deamidate glutamine residues in gluten to glutamic acid. Deamidation produces a negative charge in gluten peptides, which increases their binding to HLA-DQ2 and DQ8 thereby potentiating their capacity to stimulate T-cells. T-cells are part of the bodies immune system, and this abnormal activation leads the T-cells to injure the person's own small intestine leading to the changes I described above. These changes as well as cross-linking gluten lead to the diarrhea and flatulance associated with celiac sprue. This also makes sense as to the treatment... i.e. don't eat foods with gluten (sometimes easier said than done).

I hope this helps; let me know if you need more... because, as I am sure you can guess, there is much more out there.

Answer 2

Celiac sprue is a hereditary trait with an allergic reaction in the intestines to a certain substance of certain food. This substance is called 'gluten'. This reaction causes malabsorption and consequently diarrhea.

Answer 3

Great answers. I just wanted to add a link to http://www.glutenfreeforum.com .

It's a great GF support forum.

Nancy