Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in certain grains like wheat, barley and rye. With Celiac Disease, eating gluten triggers an immune response in the small intestine.
Gluten is a family of storage proteins that consist primarily of two major amino acid sequences the gliadins and the glutenins. Glutenin is a major protein in wheat flour, for example, making up 47% of its total protein content. People with Celiac Disease are sensitive to α (alpha), β (beta) and γ(gamma) gliadins. Sensitivity may also develop to ω-gliadins (omega).
Over time, the immune reaction to gluten damages the lining of the small intestine which reduces or prevents the absorption of some nutrients (malabsorption). The intestinal damage can cause diarrhea, fatigue, weight loss, bloating and anemia, and can lead to other complications.
Celiac Disease is believed to be hereditary and linked to one or both of the HLA-DQ2 and HLA-DQ8 genes. However, while it is estimated that 30% of the population has one or both of the genes, only 1% of that number develop the disorder. Environmental factors and stressors that may play role in activating the disease in those susceptible, include illness and trauma.
It has been hypothesized that intestinal infections, the amount and quality of gluten, the intestinal microbiota, and early nutrition are all possible triggers of the switch from tolerance to an immune response to gluten.