Aitella Ernesto, Cozzolino Domenico, Ginaldi Lia, Romano Ciro
Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Allergy and Clinical Immunology Unit, "G. Mazzini" Hospital, ASL Teramo, 64100 Teramo, Italy.
Nutrients. 2025 Jan 10;17(2):234. doi: 10.3390/nu17020234.
Celiac disease (CeD) is a chronic, lifelong, multifactorial, polygenic, and autoimmune disorder, characteristically triggered by exposure to the exogenous factor "gluten" in genetically predisposed individuals, with resulting duodenal inflammation and enteropathy, as well as heterogeneous multisystemic and extraintestinal manifestations. The immunopathogenesis of CeD is complex, favored by a peculiar human leukocyte antigen (HLA) genetic predisposition, leading to gluten presentation by antigen-presenting cells to CD4+ T helper (Th) cells, T cell-B cell interactions, and production of specific antibodies, resulting in the immune-mediated killing of enterocytes and, macroscopically, in duodenal inflammation. Here, the most relevant correlations between cellular and molecular aspects and clinical manifestations of this complex disease are reviewed, with final considerations on nutritional aspects for disease management.
乳糜泻（CeD）是一种慢性、终身性、多因素、多基因的自身免疫性疾病，其特征是在具有遗传易感性的个体中，接触外源性因素“麸质”后引发，导致十二指肠炎症和肠病，以及异质性的多系统和肠外表现。CeD的免疫发病机制很复杂，受到特殊的人类白细胞抗原（HLA）遗传易感性的影响，导致抗原呈递细胞将麸质呈递给CD4+辅助性T（Th）细胞，T细胞与B细胞相互作用，并产生特异性抗体，从而导致免疫介导的肠上皮细胞杀伤，在宏观上表现为十二指肠炎症。本文综述了这种复杂疾病在细胞和分子层面与临床表现之间的最相关关联，并对疾病管理中的营养方面进行了最终考量。
