Volume 2 Issue 1 - 2018
The Celiac Disease & the Microbial Flora
Aziz Koleilat*
Makassed University General Hospital, Department of pediatrics, Beirut -Lebanon
*Corresponding Author: Aziz Koleilat, Makassed University General Hospital, Department of pediatrics, Beirut -Lebanon.
Received: June 04, 2018; Published: June 06, 2018
Keywords: Microbial flora; Celiac; Cytokines; Probiotic; Breast feeding; Fecal transplant
A lifelong immune-mediated, multisystem disorder that develop in genetically predisposed individuals when exposed to dietary gluten, Characterized by elevated titers of celiac-specific autoantibodies, and inflammatory enteropathy with a wide range of gastrointestinal and extra-intestinal manifestations and problems (S. Guandalini, 2014).
The celiac individuals have abnormal microbial flora compared to healthy ones. There is dysbiosis of the microbial flora with villus atrophy and lymphocytes in the villous architecture.
(Chang F 2005)
The dysbiosis could be a cause and a result in the course of the disease.
The microbial dysbiosis is the imbalance of the microbial flora of the person concerned where bacteria with inflammatory cytokine overcome those with anti-inflammatory cytokines.
Reduction in Bifidobacteria species and/or Lactobacillus species relative to gram negative bacteria and pathobionts which have the potential to aggregate and maybe a predisposing factor in the course of the disease with their production of inflammatory cytokine especially after the ingestion of gliadin. The inflammatory cytokines include interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), and interleukin 12 (IL-12) (E. Leonetti., et al. 2011).
Studies mentioned that breast feeding may ameliorate the symptoms and delay it manifestation, by acting on the tight junctions and keep the microbial flora in balance. “The effect of the good bacteria, the bifidogenic nature of the breast milk”.
Also, studies show that the alteration of the composition of the microbial flora of the celiac patient by the good flora produce anti-inflammatory cytokines which counter effect the inflammatory cytokines which are elicited by the pathogenic bacteria. (Di Cagno R., et al. 2011) (Nóra Judit Béres., et al. 2014). (K. Lindfors., et al. 2008).
So the question is Can designed probiotic or fecal transplant of a heathy patient change the course of cealiac disease and decrease or stop the intestinal and extra intestinal manifestation of the disease??? (Fasano Jose U., et al. 2016).
  1. S. Guandalini, Celiac Disease: A Review, JAMA Pediatrics, January 6, (2014).
  2. Chang F 2005 Pathological and clinical significance of increased intraepithelial lymphocytes (IELs) in small bowel mucosa; APMIS. 113.6 (2005): 385-399.
  3. E Lionetti and C Catassi. “New clues in celiac disease epidemiology, pathogenesis, clinical manifestations, and treatment.” International Reviews of Immunology 30.4 (2011): 219-231.  
  4. K Lindfors T., et al. “Live probiotic Bibdobacterium lactis bacteria inhibit the toxic effects induced by wheat gliadin in epithelial cell culture.” Clinical and Experimental Immunology 152.3 (2008): 552-558.
  5. Di Cagno R., et al. “Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization”. BMC Microbiology (2011): 219.
  6. Nóra Judit Béres., et al. “Role of the Microbiome in Celiac Disease.” International Journal of Celiac Disease 2.4 (2014): 150-153.  
  7. Fasano Jose U Scher. “The microbiome in celiac disease: Beyond diet-genetic interactions.” Cleveland Clinic Journal of Medicine 83.3 (2016): 228-230.
Citation: Aziz Koleilat. “The Celiac Disease & the Microbial Flora”. Medical Research and Clinical Case Reports 2.1 (2018): 111-112.
Copyright: © 2018 Aziz Koleilat. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.