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Link found between gluten intolerance and cystic fibrosis

04.12.2018

An international research team from Italy and France has discovered a new "culprit" in the development of celiac disease - a mutation in the gene for the transmembrane regulator of cystic fibrosis. The discovery allows the development of therapeutic approaches for the treatment of celiac disease.

Celiac disease is a severe bowel disorder caused by damage to the villi of the small intestine from certain foods that contain certain proteins. Among these proteins, gluten (gluten) is a substance found in wheat, rye and barley.

Some people are genetically predisposed to this disease, but the mechanism of the disease is triggered by external factors. When people with celiac disease eat a diet containing gluten, their immune system triggers a response against their own cells, damaging the lining of the small intestine. About 1 in 100 people suffer from celiac disease, and it most often occurs in patients suffering from an inherited disease such as cystic fibrosis (cystic fibrosis). "This coincidence made us wonder if there is a link between the two diseases at the molecular level," said Luigi Mayuri from the University of Eastern Piedmont (Italy).

Cystic fibrosis is characterized by the accumulation of a thick layer of sticky mucus in the patient's lungs or intestines. This disease is caused by mutations in the cystic fibrosis transmembrane regulator (CFTR) gene. The eponymous protein, regulated by this gene, is involved in the transport of chloride ions across the cell membrane and plays an important role in maintaining the level of mucous fluid - when it fails, the mucus becomes clogged. In addition, CFTR failure causes a number of additional reactions in the lungs and other organs, including the intestines, by activating the immune system. These effects are very similar to the body's responses to gluten in celiac patients. Scientists have taken a closer look at the molecular basis of these similarities.

Gluten is difficult to digest, so relatively long protein parts - peptides - enter the intestines. Using gluten-sensitive human intestinal cell lines, the researchers found that one specific peptide, P31-43, directly binds to CFTR and impairs its function.

Moreover, it appears that the interaction between P31-43 and CFTR can be interrupted by a CFTR amplifier called the VX-770. To test this, scientists conducted an experiment. First, they implanted VX-770 into intestinal cells or into tissue samples collected from patients with celiac disease. Then they were exposed to P31-43 - and the peptide did not cause an immune response. Thus, the researchers concluded that VX-770 protects gluten-sensitive epithelial cells from the harmful effects of gluten. In addition, the researchers found that VX-770 could relieve gluten-sensitive mice from symptoms of intestinal disease caused by the protein.

So far, there is no cure for celiac disease. The only therapeutic strategy is to follow a strict diet. However, the current study is a promising step towards the development of a suitable therapy. Drugs that have been developed to treat cystic fibrosis could also be explored as a starting point for drug development for celiac disease, the study found.

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