Commentary
See article on page 502The external world of gluten and autoimmunity
| The first 150 words of the full text of this article appear below. |
This commentary is not about autoimmune diseases, and therefore
I will not discuss why a significant proportion of individuals are
prone to develop autoimmune diseases. Suffice to say that this failure
to spare self might represent an advantage when fighting infections. In
autoimmunity there is a clear genetic involvement with a strong
association between these diseases and some HLA alleles,1
but autoimmunity is not simply genetically controlled and environmental
factors are essential. For example, in the syngenic NOD mice, the
preferred animal model for type 1 diabetes, simple modifications in the
"cleanness" of the housing conditions dramatically changes the
incidence of the disease.2 More poignantly, in the context
of a clinical setting, the concordance rate of autoimmune diseases in
monozygous (genetically identical) twins is less than 50%.3 Hence environmental factor(s) are essential in
induction of autoimmunity. Thus characterisation of "environmental"
triggers and how they might promote autoimmunity is of paramount
importance
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- Duration of gluten exposure in adult coeliac disease does not correlate with the risk for autoimmune disorders
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