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The gluten response in children with celiac disease is directed toward multiple gliadin and glutenin peptides

      Abstract

      Background & Aims: Gluten (GLU)-specific T-cell responses in HLA-DQ2 positive adult celiac disease (CD) patients are directed to an immunodominant α-gliadin (GLIA) peptide that requires deamidation for T-cell recognition. The aim of the current study was to determine which GLU peptide(s) are involved early in disease. Methods: We have characterized the GLU-specific T-cell response in HLA-DQ2 positive children with recent onset CD. Results: We found that 50% of these patients do not respond to the α-GLIA peptide but to a diverse set of GLIA and glutenin (GLT) peptides, including 6 novel epitopes. Moreover, individual patients respond to distinct (combinations of) GLU peptides. T-cell cross-reactivity toward homologous GLIA and GLT peptides was observed, which might play a role in the initial spreading of the GLU-specific T-cell response. Although all pediatric patients displayed deamidation-dependent responses, deamidation-independent responses were found in the majority of patients as well. Finally, T-cell responses to 3 of these novel GLU peptides were found in adult CD patients. Conclusions: The diversity of the GLU-specific T-cell response is far greater than was previously appreciated. Both adult and young CD patients can respond to a diverse repertoire of GLU peptides. The observation that T-cell responses to 3 of the novel peptides are independent of deamidation indicates that T-cell responses can be initiated toward native GLU peptides. The possibility that deamidation drives the GLU response toward immunodominant T-cell stimulatory peptides after disease initiation is discussed.
      GASTROENTEROLOGY 2002;122:1729-1737

      Abbreviations:

      CD (celiac disease), GLIA (gliadin), GLT (glutenin), GLU (gluten), TCC (T-cell clone), tTG (tissue transglutaminase)
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