Coeliac disease research and clinical practice: maintaining momentum into the twenty-first century

Baillieres Clin Gastroenterol. 1995 Jun;9(2):395-412. doi: 10.1016/0950-3528(95)90037-3.


Recent research shows that each word in the definition of coeliac disease, permanent gluten sensitive enteropathy, must now be reviewed, revised or reinterpreted. Permanent--but there are now well-documented cases of acquired disease, and perhaps also partial recovery of gut gluten tolerance. Enteropathy--gluten sensitivity is expressed in a spectrum, with a mild form seen as normal architecture with high count of intraepithelial lymphocytes. Gluten--the provoking agent--Investigators are intensively working to identify the precise toxic sequence, and to establish how this will link in with new genetic information. Mechanism of sensitivity? or hypersensitivity?--Critical to this is new knowledge on the modulation and regulation of immunity to intestinal antigens, including gliadin. A hypothesis is presented, as to the pathogenesis of gluten-sensitive enteropathy, which combines concepts of oral tolerance and of the regulation of expression of delayed type hypersensitivity reactions in the gut mucosa.

Publication types

  • Review

MeSH terms

  • Celiac Disease / diagnosis*
  • Celiac Disease / etiology
  • Celiac Disease / genetics
  • Celiac Disease / immunology
  • Complement Activation / immunology
  • Forecasting
  • Glutens / adverse effects*
  • Glutens / immunology
  • Histocompatibility Antigens Class I / genetics
  • Histocompatibility Antigens Class II / genetics
  • Humans
  • Hypersensitivity, Delayed / genetics
  • Hypersensitivity, Delayed / immunology
  • Immune Tolerance / genetics
  • Immune Tolerance / immunology
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology
  • Lymphocyte Activation / genetics
  • Lymphocyte Activation / immunology
  • Research


  • Histocompatibility Antigens Class I
  • Histocompatibility Antigens Class II
  • Glutens