Müller Lucyna, Szaflarska-Popławska Anna
Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii, Uniwersytet Mikołaja Kopernika w Toruniu, Collegium Medicum im. L. Rydygiera w Bydgoszczy.
Przegl Lek. 2005;62(2):123-7.
Celiac disease results from genetic abnormal immune response to gluten. This leads to local activation of immune system. There are several clinical manifestations of the disease (e.g. active, silent and latent). Fundamental processes of celiac disease occur in small intestine mucosa. As a result of immunological reactions the development of inflammatory process with typical histopathological lesions is observed. In pathogenesis of celiac disease immunological cellular response with significant role of T lymphocytes is of great importance. According to one hypothesis in the disease non proliferative activation of lamina propria CD4+ lymphocytes and proliferative activation of intra-epithelial TcR alpha/beta CD8+ and TcR gamma/delta lymphocytes is postulated. Probably in immunological reaction to gluten besides T lymphocytes other cells are involved (lymphocytes B, NK cells, neutrophils, eosinophils, macrophages, mastocytes) but their role was not clearly established. Recently in pathogenesis of celiac disease participation of cytokines produced locally in small intestine is often emphasized.
乳糜泻是由对麸质的遗传性异常免疫反应引起的。这会导致免疫系统的局部激活。该疾病有多种临床表现（如活动型、隐匿型和潜伏型）。乳糜泻的基本过程发生在小肠黏膜。由于免疫反应，会观察到具有典型组织病理学病变的炎症过程的发展。在乳糜泻的发病机制中，T淋巴细胞起重要作用的免疫细胞反应至关重要。根据一种假说，该疾病假定固有层CD4 +淋巴细胞的非增殖性激活以及上皮内TcRα/β CD8 +和TcRγ/δ淋巴细胞的增殖性激活。在对麸质的免疫反应中，除了T淋巴细胞外，可能还涉及其他细胞（B淋巴细胞、NK细胞、中性粒细胞、嗜酸性粒细胞、巨噬细胞、肥大细胞），但其作用尚未明确确定。最近，在乳糜泻的发病机制中，小肠局部产生的细胞因子的参与常常受到强调。
