PDF(Pubmed)
Abstract：
Celiac disease (CD) presents a complex interplay of both innate and adaptive immune responses that drive a variety of pathological manifestations. Recent studies highlight the role of immune-mediated pathogenesis, pinpointing the involvement of antibodies against tissue transglutaminases (TG2, TG3, TG6), specific HLA molecules (DQ2/8), and the regulatory role of interleukin-15, among other cellular and molecular pathways. These aspects illuminate the systemic nature of CD, reflecting its wide-reaching impact that extends beyond gastrointestinal symptoms to affect other physiological systems and giving rise to a range of pathological landscapes, including refractory CD (RCD) and, in severe cases, enteropathy-associated T cell lymphoma. The existing primary therapeutic strategy, a gluten-free diet (GFD), poses significant challenges, such as low adherence rates, necessitating alternative treatments. Emerging therapies target various stages of the disease pathology, from preventing immunogenic gluten peptide absorption to enhancing intestinal epithelial integrity and modulating the immune response, heralding potential breakthroughs in CD management. As the understanding of CD deepens, novel therapeutic avenues are emerging, paving the way for more effective and sophisticated treatment strategies with the aim of enhancing the quality of life of CD patients. This review aims to delineate the immunopathology of CD and exploring its implications on other systems, its complications and the development of novel treatments.
摘要：
乳糜泻(CD)表现出驱动多种病理表现的先天和适应性免疫应答两者的复杂相互作用。最近的研究强调了免疫介导的发病机制的作用，精确定位针对组织转谷氨酰胺酶（TG2，TG3，TG6）的抗体的参与，特异性HLA分子（DQ2/8），以及白细胞介素-15在其他细胞和分子途径中的调节作用。这些方面阐明了CD的系统性，反映了其广泛的影响，超越了胃肠道症状，影响其他生理系统，并产生了一系列的病理景观，包括耐火CD(RCD)和，在严重的情况下，肠病相关T细胞淋巴瘤。现有的主要治疗策略，无麸质饮食（GFD），带来重大挑战，如低依从率，需要替代疗法。新兴疗法针对疾病病理的各个阶段，从防止免疫原性谷蛋白肽吸收到增强肠上皮完整性和调节免疫反应，预示着CD管理的潜在突破。随着对裁谈会认识的加深,新的治疗途径正在出现，为更有效和复杂的治疗策略铺平道路，目的是提高CD患者的生活质量。这篇综述旨在描述CD的免疫病理学，并探讨其对其他系统的影响。它的并发症和新的治疗方法的发展。
