Thursday, 5 November 2015

#52 Celiac disease (English)

Celiac disease 

Celiac disease is an autoimmune disorder that can occur in genetically predisposed people of all ages. This digestive disorder occurs in reaction to gluten, a protein that is found on wheat, rye and barley. The body’s immune system reacts to the gluten and causes damage to the small intestine, affecting the villi, the one in charge of promoting the absorption of nutrients. With the villi damaged, nutrients cannot be absorbed properly into the body. 

Symptoms
•     Digestive problems: abdominal bloating, pain, gas, diarrhea, plate stools
        Skin rash
        Anemia
        Musculoskeletal problems
        Growth problems (children)
        Seizures
        Tingling sensation in your legs
        Sores in mouth
        Missed menstrual periods

Organs affected 
The inflammation associated with celiac disease may lead to grater chance on developing certain gastrointestinal cancers, such like those in the small intestine or in the esophagus.  The inflammation and lack of nutrients can also lead to problems affecting many other organs and systems of the body.

How to prevent it
Celiac disease cannot be prevented. If you already have the disease, you can prevent symptoms by eating a gluten free diet.

Treatment
Currently the only treatment for this disease is to follow a strict gluten free diet. People living gluten free must void foods with wheat, rye and barely, such as bread and beer.

Similar to/ looks like
        Colic
        Crystic fibrosis
        Crohn’s disease
        Irritable bowel syndrome
        Colitis
        Osteoporosis

What happens a cellular level?
To understand the Celiac disease we have to start with Gluten, which can be found in rye, wheat and barley. Gluten can be divided in two components, gliadin and glutenin. Gliadin is the most toxic one because it is resistant to the membrane proteasis, so they remain there after gluten is digested. The whole problem begins at the top of the small intestine, in the epithelium. There the epithelial cells absorb gliadin and interleukin-15 is activated, signaling proteins for the immune system. They activate the intraepithelial lymphocytes, which can divide in three parts, the T- cells (induce the death of pathogens), the B- cells (release antibodies which neutralize foreign bodies) and natural killer cells. 

In the epithelium cells are being killed because B-cells are activating a protein. After the epithelial cells, gliadin is progresses into the Lamina Propria (layer under the epithelium) where an enzyme called transglutaminase increases gliadin’s capability to cause an immune response by deanimating it.  After this process the antigen presenting cell grab onto the gliadin using HLA-DQ2 or DQ8 receptors.  The gliadin is then presented to the gliadin-reactive T- cells through a T-cell receptor. The T-cell then trigger the release cytokines which besides being signaling proteins also destroy the cells in the villi and send out signal to continue the destruction. After the process, the T-cell and B-cells form memory cells to remember the gliadin. This cycle of destruction is repeated every time a celiac eats gluten. 

AAM

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