Is Candida albicans a trigger in the onset of coeliac disease?

Lancet. 2003 Jun 21;361(9375):2152-4. doi: 10.1016/s0140-6736(03)13695-1.


Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease. The virulence factor of C albicans-hyphal wall protein 1 (HWP1)-contains aminoacid sequences that are identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes. HWP1 is a transglutaminase substrate, and is used by C albicans to adhere to the intestinal epithelium. Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast. Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibody Formation
  • Candida albicans / pathogenicity*
  • Celiac Disease / immunology*
  • Celiac Disease / microbiology*
  • Fungal Proteins / immunology
  • Fungal Proteins / metabolism
  • Genetic Predisposition to Disease
  • Gliadin / immunology
  • Humans
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / metabolism
  • Membrane Glycoproteins / immunology
  • Membrane Glycoproteins / metabolism
  • Transglutaminases / metabolism
  • Virulence


  • Fungal Proteins
  • HWP1 protein, Candida albicans
  • Membrane Glycoproteins
  • Gliadin
  • Transglutaminases