Gluten und Immunerkrankungen

Zusammenfassung

Gluten ist der entscheidende externe Trigger der Erkrankungen Zöliakie, Dermatitis herpetiformis und Weizenallergie. Es gibt zunehmend Hinweise, dass Gluten auch bei anderen Autoimmunerkrankungen eine relevante Rolle spielt und möglicherweise eine pathogenetische Verbindung zwischen eben diesen verschiedenen immunologischen Erkrankungen schafft. So ist bei genetisch Prädispositionierten die frühe Einführung von Gluten in die Säuglingsernährung mit einer Risikoerhöhung für Typ-1-Diabetes verbunden, andererseits besteht bei Patienten mit Zöliakie eine Korrelation zwischen der Dauer der Glutenexposition und der Entstehung von Typ-1-Diabetes und anderen Autoimmunerkrankungen. Die Prävalenz von Zöliakie bei Personen mit Typ-1-Diabetes ist ca. 10-fach erhöht. Diese Assoziation zwischen Zöliakie und Typ-1-Diabetes ist zum einen durch genetische Merkmale bedingt, zum anderen werden mögliche gemeinsame pathogenetische, glutenvermittelte Mechanismen und insbesondere eine Störung der Immunregulation in der Darmmukosa angenommen.

Abstract

Gluten is the main external trigger of diseases like celiac disease, dermatitis herpetiformis and wheat allergy. There is increasing evidence that gluten might also play a relevant role in other autoimmune diseases and it is discussed as potentially common pathogenetic association between these different diseases. In genetically predisposed individuals the early introduction of gluten into infant feeding is associated with an increased risk of type 1 diabetes, on the other hand duration of gluten exposition of patients with celiac disease is correlated with an increased risk of type 1 diabetes and other autoimmune diseases. The prevalence of celiac disease in patients with type 1 diabetes is increased about 10-fold. The association between celiac disase and type 1 diabetes is determined by the shared genetic features, also other common pathogenetic mechanisms involving gluten are hypothesised, in particular a dysfunctional immune regulation in the mucosa.

Schlüsselwörter

Gluten - Gliadin - Zöliakie - Typ-1-Diabetes - Weizenallergie - Autoimmunität

Key words

gluten - gliadin - celiac disease - type 1 diabetes - wheat allergy - autoimmunity

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