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Is Candida albicans a trigger in the onset of coeliac disease?
W F Nieuwenhuizen, R H H Pieters, L M J Knippels, M C J F Jansen, S J Koppelman
Lancet 2003; 361: 2152–54
Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease.
The virulence factor of C albicans—hyphal wall protein 1 (HWP1)—contains aminoacid sequences that are identical or highly homologous to known coeliac disease-related a -gliadin and g -gliadin T-cell epitopes. HWP1 is a transglutaminase substrate, and is used by C albicans to adhere to the intestinal epithelium. Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast.
Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium.
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