INSERM U989, Université Paris Descartes, Paris, France.
Gut. 2012 Sep;61(9):1355-64. doi: 10.1136/gutjnl-2011-300327. Epub 2011 Sep 2.
Coeliac disease is a gut disease driven by an abnormal immune response towards dietary gluten in genetically susceptible individuals. Whether and, if so, how abnormal transport of gluten across the gut epithelium may participate in the pathogenesis of coeliac disease remains debatable. This paper summarises the interactions of gluten-derived peptides with the intestinal epithelium and discusses the mechanisms that control their transport across the epithelium. It shows how recent data point to a key role for the transcellular pathway and highlights the 'Trojan horse' role of secretory IgA which can hijack the transferrin receptor and allow the rapid translocation of intact gluten peptides into the mucosa. These recent findings might be useful for the design of new treatments.
乳糜泻是一种由遗传易感个体对膳食 gluten 的异常免疫反应引起的肠道疾病。谷蛋白穿过肠上皮的异常转运是否以及如何参与乳糜泻的发病机制仍存在争议。本文总结了谷蛋白衍生肽与肠道上皮的相互作用，并讨论了控制其穿过上皮转运的机制。它展示了最近的数据如何指向跨细胞途径的关键作用，并强调了分泌型 IgA 的“特洛伊木马”作用，它可以劫持转铁蛋白受体并允许完整的 gluten 肽快速转移到黏膜中。这些新发现可能有助于设计新的治疗方法。
