Coeliac disease

Mechanisms of epithelial translocation of the ₂-gliadin-33mer in coeliac sprue

M Schumann¹, J F Richter², I Wedell¹, V Moos¹, M Zimmermann-Kordmann³, T Schneider¹, S Daum¹, M Zeitz¹, M Fromm², J D Schulzke¹

¹ Department of Gastroenterology, Charité, Campus Benjamin Franklin, Berlin, Germany
² Institute of Clinical Physiology, Charité, Campus Benjamin Franklin, Berlin, Germany
³ Institute for Biochemistry und Molecular Biology, Charité, Campus Benjamin Franklin, Berlin, Germany

ProfessorDr Joerg D Schulzke, Klinik für Gastroenterologie, Charité, Campus Benjamin Franklin, 12200 Berlin, Germany; joerg.schulzke{at}charite.de

Background and aims: The ₂-gliadin-33mer has been shown to be important in the pathogenesis of coeliac disease. We aimed to study mechanisms of its epithelial translocation and processing in respect to transcytotic and paracellular pathways.

Methods: Transepithelial passage of a fluorescence-labelled ₂-gliadin-33mer was studied in Caco-2 cells by using reverse-phase high-performance liquid chromatography, mass spectrometry, confocal laser scanning microscopy (LSM) and fluorescence activated cell sorting (FACS). Endocytosis mechanisms were characterised with rab-GFP constructs transiently transfected into Caco-2 cells and in human duodenal biopsy specimens.

Results: The ₂-gliadin-33mer dose-dependently crossed the epithelial barrier in the apical-to-basal direction. Degradation analysis revealed translocation of the 33mer polypeptide in the uncleaved as well as in the degraded form. Transcellular passage was identified by confocal LSM, inhibitor experiments and FACS. Rab5 but not rab4 or rab7 vesicles were shown to be part of the transcytotic pathway. After pre-incubation with interferon-, translocation of the 33mer was increased by 40%. In mucosal biopsies of the duodenum, epithelial 33mer uptake was significantly higher in untreated coeliac disease patients than in healthy controls or coeliac disease patients on a gluten-free diet.

Conclusion: Epithelial translocation of the ₂-gliadin-33mer occurs by transcytosis after partial degradation through a rab5 endocytosis compartment and is regulated by interferon-. Uptake of the 33mer is higher in untreated coeliac disease than in controls and coeliac disease patients on a gluten-free diet.

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