Intestinal Microbiota and Celiac Disease

Marta Olivares, Yolanda Sanz

Resumen


Intestinal microbiota is constituted by a particular assembly of bacteria that develop symbiotic relationships with their host, contributing to diverse physiological functions and determining resilience to disease. Diverse environmental and intrinsic factors can upset this symbiotic relationship, shifting the ecosystem from a state of eubiosis to one of dysbiosis, which causes functional modifications and promotes disease. Indeed, immune dysfunction frequently coincides with intestinal dysbiosis and one can occur as a result of the other, creating a vicious circle. On this basis, hypotheses suggest that a dysbiotic gut microbiota could influence the onset and progression of celiac disease (CD). Epidemiological studies indicate that common perinatal and early postnatal factors influencing CD risk also affect the intestinal microbiota structure. A recent prospective study of healthy infants at family risk of developing CD has also revealed that the HLA-DQ genotype influences the microbiota composition. Several studies have also shown imbalances in the intestinal microbiota of CD patients, which are not fully normalized despite their adherence to a gluten-free diet, thus suggesting that such imbalances are not just a secondary consequence of CD. Furthermore, two small intervention studies have recently reported potential interest in the use of specific bifidobacteria to improve CD treatment, although larger human trials are required to confirm the benefits. Altogether, findings indicate that gut microbiota composition and function may be one of the missing pieces in the CD puzzle that could help to fully explain disease pathogenesis and risk. Thus, it is interesting to investigate new strategies for CD management that target gut microbiota within this research field.


Palabras clave


microbiota, celiac disease, Bifidobacterium, probiotics

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