Profiling Celiac Disease-Related Transcriptional Changes

Celiac disease (CD) is a chronic, autoimmune disease of the small intestine with a strong but complex genetic component. The disease is triggered by the consumption of dietary gluten through the presentation of immunogenic gliadin peptides to T helper lymphocytes by HLA-DQ2 and DQ8 heterodimers, which are the major contributors to the genetic risk. Recent large-scale genotyping efforts have identified a large number of additional association signals, but the functional role of the underlying genes in the pathogenesis of the disease is still unclear. In the last years, several whole transcriptome analyses have been performed in different tissues, including whole duodenal biopsies, isolated gut epithelial cells or peripheral blood from gluten-consuming CD patients at diagnosis, treated patients on gluten-free diet and nonceliac controls, sometimes after in vitro challenge with gluten-derived gliadin peptides. Although the results from the different experiments are difficult to reconcile, the main findings point to an exacerbation of the immune response, together with the dysregulation of signaling and cell cycle pathways. The effect of associated SNPs on the expression of candidate genes and the role of the noncoding genome are the new territories that the CD research community has only begun to explore.