In patients with celiac disease, but not in healthy controls, gluten-specific CD4 T cells are present in the small intestinal lamina propria. Specific stimulation of these T cells due to gluten consumption leads to the release of pro-inflammatory cytokines, in particular IFNγ and IL-21. This leads to tissue damage, the typical morphological alterations like the flattening of the intestinal epithelium, and a variety of disease-associated symptoms including malnutrition, diarrhea, stomach ache, and failure to thrive. Removal of gluten from the diet eliminates the trigger for these CD4 T cells and leads to recovery. These CD4 T cells thus play a crucial role in the disease pathogenesis. Here we describe how such T cells can be isolated and characterized.
Keywords: CD4 T cells; Celiac disease; Gluten; HLA-DQ2; HLA-DQ8.