Investigating the relationship between the immune system and coeliac disease

Professor Frits Koning is an immunologist with a special interest in gastrointestinal diseases. He was granted funding by Coeliac UK to investigate the relationship between coeliac disease and the immune system, provide better understanding of the development of the disease and possible prevention strategies or new target areas for personal treatment.

What was the main issue you wanted to address?

Put simply, the research aimed to understand how the two arms of the immune system are involved in coeliac disease. To explain in more detail, the immune system is complex and can make both adaptive and innate responses. Adaptive responses lead to immunological memory – which means that once a response has been made by a person’s immune system they are then immune and respond stronger the next time they are exposed to the same pathogen (which can be bacteria or a virus that can cause illness - a good example is the way that you become less likely to pick up an illness when you’ve already had it once). Of course, in people with coeliac disease the immune system mistakenly treats gluten as a pathogen, so the only treatment is a lifelong gluten free diet, to avoid reactivation of the memory response outlined above. The innate immune system is a first line of defence and if and how this is involved in coeliac disease remains unclear. Improving our understanding of the immune system and gluten could potentially help people with coeliac disease in several ways: from finding targets for alternative treatments to even preventing the onset of the condition in the first place.

What were you hoping to find out through this research? How successful were you?

Thanks to a new technique we were able to study the immune system in an entirely different way. We were hoping that this would reveal which components of the immune system derail when coeliac disease develops. The result is that we have obtained strong evidence that multiple components of the immune system are involved – from both the adaptive and innate parts.

What are the key things you learned from this project?

The most important coeliac disease-associated changes in the immune system are found in intestinal biopsies (where some tissue from the small intestine is examined). These changes are found in both the adaptive and innate parts of the immune system. We also noticed changes to the immune system within patients’ blood samples and have gained new insight into the cell type involved in the development of refractory coeliac disease.

How will this project benefit people with coeliac disease?

The fact that we have found coeliac disease associated changes in blood samples could lead to the improvement of diagnosis procedures. And in the long run, a better understanding of how the immune system responds can help us find out why coeliac disease patients respond to gluten in the way they do. This may even lead to finding out how to prevent this reaction in the future.

How has the funding from Coeliac UK made a difference?

The funding has allowed us to gain confidence in the new technique and has laid down solid groundwork for further research which can shed new light on the involvement of the immune system in coeliac disease.

Principle Investigator: Professor Frits Koning

Institution: Department of Immunology and Blood Transfusion, Leiden University Medical Centre

Grant awarded: £50k