Zusammenfassung
Gluten ist der entscheidende externe Trigger der Erkrankungen Zöliakie, Dermatitis
herpetiformis und Weizenallergie. Es gibt zunehmend Hinweise, dass Gluten auch bei
anderen Autoimmunerkrankungen eine relevante Rolle spielt und möglicherweise eine
pathogenetische Verbindung zwischen eben diesen verschiedenen immunologischen Erkrankungen
schafft. So ist bei genetisch Prädispositionierten die frühe Einführung von Gluten
in die Säuglingsernährung mit einer Risikoerhöhung für Typ-1-Diabetes verbunden, andererseits
besteht bei Patienten mit Zöliakie eine Korrelation zwischen der Dauer der Glutenexposition
und der Entstehung von Typ-1-Diabetes und anderen Autoimmunerkrankungen. Die Prävalenz
von Zöliakie bei Personen mit Typ-1-Diabetes ist ca. 10-fach erhöht. Diese Assoziation
zwischen Zöliakie und Typ-1-Diabetes ist zum einen durch genetische Merkmale bedingt,
zum anderen werden mögliche gemeinsame pathogenetische, glutenvermittelte Mechanismen
und insbesondere eine Störung der Immunregulation in der Darmmukosa angenommen.
Abstract
Gluten is the main external trigger of diseases like celiac disease, dermatitis herpetiformis
and wheat allergy. There is increasing evidence that gluten might also play a relevant
role in other autoimmune diseases and it is discussed as potentially common pathogenetic
association between these different diseases. In genetically predisposed individuals
the early introduction of gluten into infant feeding is associated with an increased
risk of type 1 diabetes, on the other hand duration of gluten exposition of patients
with celiac disease is correlated with an increased risk of type 1 diabetes and other
autoimmune diseases. The prevalence of celiac disease in patients with type 1 diabetes
is increased about 10-fold. The association between celiac disase and type 1 diabetes
is determined by the shared genetic features, also other common pathogenetic mechanisms
involving gluten are hypothesised, in particular a dysfunctional immune regulation
in the mucosa.
Schlüsselwörter
Gluten - Gliadin - Zöliakie - Typ-1-Diabetes - Weizenallergie - Autoimmunität
Key words
gluten - gliadin - celiac disease - type 1 diabetes - wheat allergy - autoimmunity
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PD Dr. med. Michael Hummel
Institut für Diabetesforschung
Kölner Platz 1
80804 München
Phone: 089/30682591
Fax: 089/3081733
Email: Michael.Hummel@lrz.uni-muenchen.de