
Type 1 diabetes mellitus and gluten induced disorders
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Introduction
Coeliac Disease (CD), also referred to as gluten-sensitive enteropathy, is an autoimmune condition that occurs in genetically predisposed people by exposure to gluten. Initially mentioned in literature in the second century AD, CD was described as an intestinal disorder with symptoms of diarrhoea, malabsorption and weight loss. Recently, it has become clear that there is a group of conditions related to gluten consumption. Foremost among them are three types: a) the least common is wheat allergy; b) the autoimmune form, the best characterized, includes CD, dermatitis herpetiformis, and gluten ataxia; and c) sensitivity to gluten, which is possibly immune-mediated and now the most common (1). An association between gluten and CD was only established much later, by Dicke (1953), who found that the removal of gluten from patients’ diets led to the improvement of symptoms (2).
Gluten and gluten toxicity
Gluten is a protein constituent found in wheat, rye, and barley. It is gluten that gives dough its elasticity, helps it rise and contributes to the texture of many food products such as bread, pasta, or imitation meats (3,4). Specifically the storage proteins (prolamins) gliadin (wheat), secalin (rye), and hordein (barley) have been shown to have toxic effects on intestinal cells in gluten sensitive people. The toxic effects of these prolamins include the reduction of F-actin, inhibition of cellular growth, premature cell death, the rearrangement of the cytoskeleton, and increased small bowel permeability (5).
Symptoms and associations of CD
Despite a stron
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