Flashcards in Coeliac disease Deck (16):
What is Coeliac disease?
Gluten sensitive enteropathy
- It is a genetically linked disease that causes damage to the small intestine leading to malnutrition, due to gluten.
What is the antigenic target in coeliac disease?
e.g. Wheat, rye and barley
What is the genetic susceptibility in Coeliac disease?
How is the immunopathology in Coeliac disease carried out?
T cell mediated
Inta-epithelial lymphocyte mediates
What does coeliac disease lead to?
What does coeliac disease causes pathologically to the gut?
Increase in cellular infiltrate
What is the consequence of the villous atrophy?
Reduced surface area
What is the scale used to measure the severity of coeliac disease?
The Modified MARSH score
Explain the mechanism and trigger by which coeliac disease occurs?
Gluten peptides active mucosal epithelial cells
The activated cell express MIC molecules (stress response)
IEL cells detect the stress markers
IEL cells bind to the MIC marker and program the cell to induce cell death.
Explain the mechanism of coeliac disease that does not involve stress signals?
Gluten peptides naturally do not bind to MHC class 2
Dysfunction transglutaminase modifies the gluten peptides to bind to MHC class 2
Gluten antigen activates specific CD 4 T cells
Activates T cell kills the epithelial cells
The T cells secrete IFN gamma that activates the epithelial cell.
How is coeliac disease diagnosed?
Biopsy - gold standard
Serology - testing for IgA anti-tissue transglutaminase autoantibodies.
What cell reacts to the transgluatminase enzyme and what does not do?
B cell react to it..
The B cell then produce an enzyme of anti-tTG- antibodies.
What are the symtpoms of coeliac disease?
Weight loss - major symptom
Diarrhoea - major symptom
Anaemia - major symptom
What is the treatment for coeliac disease?
Life long gluten free diet
What are complications of Coeliac disease?
T cell lymphoma