The interaction between diet and inflammation is critical in managing chronic inflammatory diseases. Gluten, a protein found in wheat, barley, and rye, has been linked to various health issues, particularly celiac disease (CD). This review, based on a recent study published in Journal of Translational Gastroenterology, examines gluten’s pro-inflammatory effects and its broader implications for autoimmunity.
Gluten comprises primarily glutenin and gliadin, with gliadin making up about 70% of the protein. Gliadin is notably implicated in adverse immune responses, especially in CD. Given gluten’s prevalence in Western diets, its impact extends beyond CD, suggesting a broader role in inflammation and autoimmune conditions.
Celiac disease is an autoimmune disorder driven by gluten, particularly gliadin peptides, which cause intestinal injury and activate inflammatory pathways. These peptides lead to mucosal inflammation, epithelial damage, and altered gut microbiota. Removal of gluten from the diet alleviates these symptoms, highlighting gluten’s central role in CD pathology.
Gluten’s effects are not limited to CD. It can impair gut permeability, allowing immunogenic molecules to access other body parts and trigger autoimmune responses. Gliadin peptides may contribute to autoimmune diseases beyond CD, including dermatitis herpetiformis, gluten ataxia, and gluten allergy, as well as potential non-celiac inflammatory and neurodegenerative conditions.
Despite its inflammatory properties, gluten has been a staple in human diets, providing fiber, B vitamins, and minerals. However, it is not essential for health, and its removal does not adversely affect well-being except in gluten-dependent disorders. The rise of gluten-free diets, driven by some pseudoscientific claims, impacts dietary habits. A gluten-free Mediterranean diet may offer a balanced approach, combining the benefits of both dietary strategies.
Gluten’s pro-inflammatory and pro-oxidative activities can disrupt gut function and lead to health issues. Gliadin peptides induce cellular stress, activate inflammatory pathways, and affect critical cellular processes. Changes in gut microbiota and enzymatic modifications related to gluten can contribute to autoimmune responses through molecular mimicry.
Gluten significantly influences celiac disease and may also play a role in other autoimmune and inflammatory conditions. Understanding gluten’s harmful effects underscores the need for further research into its role in non-celiac diseases. While avoiding gluten can improve outcomes in gluten-dependent conditions, a gluten-free Mediterranean diet is recommended for balanced nutrition. This review provides insights into gluten-mediated inflammation and suggests potential therapeutic approaches.