Role of gluten-free diet in pathogenesis of type 1 diabetes – what new?

Over the last decades, the association between coeliac disease and other autoimmune disorders, such as autoimmune thyroid diseases or diabetes mellitus type 1 has been well established through many studies, and to this day is subject to an on-going clinical and scientific investigation worldwide. Type 1 diabetes (T1D) and coeliac disease (CD) share a similar genetic background, with high susceptibility associated with the HLA-DQ2/DQ8 genotype. Interplay between ingested gluten and the subsequent development of type 1 diabetes has been revealed by studies in humans and animals. The study shows that a diet without gluten reduces the level of NKG2D receptor and its ligand expression in mice on a gluten-free (GF) diets. Thus, gluten may affect diabetes development by influencing proportional changes in immune cell populations or by modifying the cytokine/chemokine pattern towards an inflammatory profile. This supports an important role for gluten intake in the pathogenesis of type 1 diabetes. It is reasonable to conduct further researchto clarify whether a gluten-free dietcould prevent disease in susceptible individuals or be used with newly diagnosed patients to stop the disease. These observations may be important for the primary prevention of diabetes.