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Defective tight junctions in refractory celiac disease
Author(s) -
Schumann Michael,
Kamel Sarah,
Pahlitzsch MarieLuise,
Lebenheim Lydia,
May Claudia,
Krauss Michael,
Hummel Michael,
Daum Severin,
Fromm Michael,
Schulzke JörgDieter
Publication year - 2012
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2012.06565.x
Subject(s) - claudin , tight junction , refractory (planetary science) , downregulation and upregulation , disease , gluten free , pathophysiology , intestinal mucosa , medicine , gluten , immune system , atrophy , immunology , pathology , biology , microbiology and biotechnology , biochemistry , astrobiology , gene
In celiac disease, the gut‐associated immune system is activated in response to the ingestion of gluten, causing an atrophy of the small intestinal mucosa. Although this condition is, in most cases, responsive to a gluten‐free diet, celiac disease refractory to treatment occurs in a small percentage of celiacs. An epithelial barrier defect is known to be an integral part of celiac pathophysiology. However, the mucosa in refractory celiac disease underlies a constant inflammatory process. The epithelial barrier has not been addressed in this condition so far. Herein, the tight junction‐associated barrier in refractory celiac disease is investigated functionally and structurally. Although normally expressed in celiac disease, claudin‐4 is shown to be downregulated in refractory cases, presumably by two mechanisms, reduced protein expression and increased claudin endocytosis. Furthermore, the tightening claudin‐5 is downregulated and the pore‐forming claudin‐2 is upregulated.