coeliac disease Flashcards
what is it
condition in which there is inflammation of the mucosa of the upper small bowel
when does mucosa improve
when gluten is withdrawn
what is gluten present in
- cereals
- wheats
- barley
- rye
what is the damaging factor of gluten
prolamins
- gliadin from gluten
- hordeins from barley
- secalins from rye
what are prolamins resistant to
digestion by pepsin and chymotrypsin because of their high glutamate and proline content
so they remain in intestinal lumen triggering immune response
what is gliadin demented by
tissue transglutaminase
what does gliagin peptide bind to
antigen-presenting cells which interact with CD4 in the lamina propria
how does gliadin interact with CD4
via HLA class II
what else does CD4 interact with
B cells to produce endomysial and tissue transglutaminase
what else can gliadin cause release of
IL-5
what does the inflammatory cascade release
metalloproteins
what does metalloproteinases contribute to
villous atrophy and crypt hyperplasia
is it genetic inherited
unsure
what virus in infancy increases risk
rotavirus
what can be seen in blood test to diagnose
- raised MCV
- iron deficiency in pregnancy
