Description
Gliadin is the main component of gluten, which occurs in wheat and other domestic grain types like rye, barley and oats, and may lead to severe diseases of the intestinal mucosa in sensitive children and adults. Celiac disease, a gluten-induced enteropathy, appears rather frequently (1 case on 300 births) and is a typical example of a non-IgE mediated food allergy. Genetically, histocompatibility antigens on the chromosome 6 are responsible for the disease. Celiac disease manifests itself practically as a constant reaction against gliadin. By the toxic effect of gluten in the intestinal tract, antibodies, cytokines and lymphocytes are released, which lead to internal lesions and inflammations. Further, the microvilli of the intestine are almost completely reduced, so that the inner intestinal surface becomes flat. The resulting malabsorption leads to a deficit of above all trace elements and vitamins. Loss of weight, diarrhea, flatulence and abdominal pain are observed as symptoms. An invasive diagnostic possibility represents the biopsy of the intestinal mucosa. In addition serological methods for the determination of IgG and IgA antibodies against gliadin, reticulin and endomysium in the patient serum are increasingly used as a screening method. For children with a gluten-sensitive enteropathy, the incidence was calculated to 90-100%, for adults with celiac disease 75- 90% and for dermatitis herpetiformis 40-50%. Elevated levels of IgA anti-gliadin demonstrate an active process and are in close correlation with a villous atrophy in children. The ELISA antibody determination is also well suited for the monitoring of patients after a gluten-free diet