Center for Celiac Research, Mucosal Immunology and Biology Research Center and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 55 Fruit Street, Jackson BLDG, RM 1402, Boston, MA, 02114, USA.
Curr Allergy Asthma Rep. 2019 Jul 18;19(9):40. doi: 10.1007/s11882-019-0871-5.
Celiac disease (CD) is an autoimmune enteropathy triggered by gluten. The purpose of this review is to examine the major genetic and environmental factors that contribute to CD pathogenesis.
We reviewed the current state of knowledge on the genetic and environmental components that play a role in CD onset. A genome-wide association study (GWAS) analysis has highlighted several genes other than HLA involved in CD. Recent studies have shown that HLA haplotype influences the microbiome composition in infants and that dysbiosis in the intestinal microflora, in turn, contributes to loss of tolerance to gluten. Recently, observational studies have discussed the hypothesis stating that breast-feeding had a protective role against CD onset. CD etiology is influenced by genetic and environmental factors. A better understanding of these components would deepen our knowledge on the mechanisms that lead to loss of tolerance and could help in developing a more "personalized medicine."
乳糜泻(CD)是一种由麸质引发的自身免疫性肠病。本文旨在探讨导致 CD 发病的主要遗传和环境因素。
我们回顾了目前关于 CD 发病中起作用的遗传和环境因素的知识状态。全基因组关联研究(GWAS)分析突出了除 HLA 以外的几个参与 CD 的基因。最近的研究表明,HLA 单倍型影响婴儿的微生物组组成,而肠道微生物群的失调反过来又导致对麸质的耐受性丧失。最近的观察性研究讨论了这样一种假设,即母乳喂养对 CD 的发病具有保护作用。CD 的病因受遗传和环境因素的影响。更好地了解这些因素将加深我们对导致耐受丧失的机制的认识,并有助于开发更“个性化的医学”。