Gluten enteropathy, also known as celiac disease, is an autoimmune disorder caused by the ingestion of gluten. Gluten is a protein found in wheat, barley, and rye that humans lack the enzymes to properly break down. In celiac disease, the immune system mistakenly attacks and damages the villi of the small intestine upon exposure to gluten. This leads to inflammation, leaky gut syndrome as gluten passes through the damaged intestinal wall, and eventually the flattening and destruction of the microvilli lining of the small intestine.

1. Gluten Enteropathy
Presentation by
Esfa khawar

2. Definition of Gluten Enteropathy
 Gluten enteropathy means disorder in small
intestine caused by the intake of Gluten
 Gluten is a protein found in wheat, barley, cereal,
pasta etc.
 In plant ,there is a defensive protein called
Prolamins »»
 Gluten is one of the type of Prolamins >> contain
toxic part Gliadin
 These toxic prolamins give the plant a protection
mechanism for their survival

3. Prolamins
 Dr. Alessio Fasano
 “All humans lack the enzymes required to break down
gluten.”
 The human gut is not equipped to break down prolamins
small enough to absorb any nutrients from them.
 This toxic affect is worse for people suffering from celiac
disease genetically.

4. Celiac Disease
 Gluten enteropathy >>also called >>Celiac
disorder
 Celiac disease is >>AUTOimmune disease
 Under normal conditions, the immune
system is designed to protect toxins,
bacteria, viruses, cancer cells, etc.

5. AUTOimmune disease
 In people with autoimmune disease,
 the immune system gets “confused” between antigen and
healthy body tissue
 it’s a tragic case of mistaken identity.
 “”The main difference between gluten intolerance and
celiac disease is the role of immune system towards
Gluten.””

6. Mechanism
 When a person intake gluten in diet (cereal, pasta ,wheat),
 enters into your stomach.
 Your stomach will reduce the size and structure of the food,
 turning it into chyme, and
 send it along to the small intestine to break it down further and
harvest the nutrients.
Intake food
Enters in
stomach
Chyme Small
intestine

7. Cont.
 In the case of gluten proteins (like gliadin), they need to
be broken down by the body before they’re useful, which
is difficult for us humans.
 Dr. Alessio Fasano
 “All humans lack the enzymes required to break down
gluten.”
 As these gliadin particles bounce around in the small
intestine, they start causing damage to the villi

8. Cont. INNATEimmune system/
inflammation
 undigested gliadin particles in the small
intestine causes a release of IL-8,(Inter
leukin) triggering the initial gut
inflammation
 IL8 activates INNATE immune system, first
layer of defense to react
 Their encounter start damaging small
intestine lining Enterocytes hence cause
GUT INFLAMATION at above gut wall.

9. LEAKY GUT
Zonulin/ tight junction
 Since INNATE immune system is not strong enough
for gliadin>>pass the barrier >> tricks ZONULINE
 (Zonulin is (Protein) a “gatekeeper” protein in the
human gut that controls the tight junctions of the
gut)
 >> cause zonulin level to rise >> Tight Junction in
return Opens Wide enough for large particle gluten
to enter inside Gut wall.
 Passing of Gluten through tight junction is called
LEAKY GUT.

10.  Now, gliadin is accumulating underneath the gut wall,
causing the enterocytes to release IL-15 (Inter leukin)
 ACTIVATES immune system Special Forces sending Intra
Epithelial Lymphocytes (IEL’s) with “inflammatory
mediators” such as TNF and IFN that
 contribute to more severe enterocyte damage
 causing inflammation
 The more severely those cells are damaged, the worse the
intestinal permeability gets
 and soon left with full-blown leaky gut syndrome.
 Now gliadin (and everything else), can freely pass through
the gut wall

11. Gliadin Cross link with Enzyme
Adaptive immune system
 Gliadin pass through gut wall >> enters underneath
the Gut Wall >> Crosslink with Enzyme Tissue
Transglutaminase (tTG)
 tTG= enzyme secreted to repair damaged Intestinal
cell Enterocytes
 >> on Crosslink of Gliadin/tTG >> ADAPTIVE immune
system enters ( special, powerful and strong
response ) contains Antibodies >> comes into
action>> recognize and destroys the antigens.

12. Cont.
 However
 Greater is the GUT Leak << Greater will be
Cross link <<
 Antibodies mistakenly start attacking
enterocyte cells ..
 this situation is called Autoimmune disease

13. 3 Inflammations
 Remember Immune system is already busy fighting Gliadin
above the Gut wall causing initial inflammation
 immune system fighting Gliadin is inside Gut Wall
causing inflammation
 Now Antibody’s mistaken attack on intestine cell
causing Inflammation.
 all three processes leading to the destruction of the
enterocyte cells lining the gut wall in their own special
way.
 Over time, these attack gets bad enough that they
completely destroy the microvilli of the intestinal lining.
 start infiltrating the body

14. Flattening
Damaged
completely

15. Summary of Mechanism
Gluten intolerance