Autoimmune diseases articles within Nature Reviews Gastroenterology & Hepatology

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  • Review Article |

    Coeliac disease is an autoinflammatory disease, with the only available treatment being a lifelong gluten-free diet. Alternative therapeutic approaches are needed. This Review explores the concept of tolerance-inducing therapies for coeliac disease, highlighting the underlying mechanisms, progress, challenges and future directions.

    • Ludvig M. Sollid

  • Perspective |

    Autoimmune diseases share patterns of gut microbiome perturbation and immune dysregulation linked to intestinal barrier dysfunction. In this Perspective, the authors examine dietary tools for precise engineering of the gut microbiome and discuss the potential for diet-based therapies to modulate host–microbiome interaction in the treatment of autoimmune diseases.

    • Mathis Wolter
    • , Erica T. Grant
    •  & Mahesh S. Desai

  • Roadmap |

    Coeliac disease is a serious condition and a model disease that can shed light into the mechanisms that underlie autoimmunity and chronic inflammation. This Roadmap summarizes key advances in coeliac disease and provides recommendations from a consensus workshop to address the gaps and opportunities in the pathogenesis, diagnosis and management of coeliac disease, providing a path forward.

    • M. Ines Pinto-Sanchez
    • , Jocelyn A. Silvester
    •  & Elena F. Verdu

  • Review Article |

    A gluten-free diet is currently the only effective treatment for coeliac disease but an increased understanding of disease pathogenesis has led to the identification of several potential therapeutic targets. This Review provides a broad overview of current and emerging therapies for coeliac disease.

    • Laura Kivelä
    • , Alberto Caminero
    •  & Katri Lindfors

  • News & Views |

    New findings show that disease-specific T cells that target gluten in patients with coeliac disease persist for decades. The data highlight a central role for a highly select and stable population of T cells in disease persistence and support the feasibility of diagnostics and therapies targeting these cells.

    • Melinda Y. Hardy
    •  & Jason A. Tye-Din

  • Review Article |

    Results from genetic studies of primary sclerosing cholangitis have identified a number of risk loci associated with the disease. Here, Jiang and Karlsen comprehensively discuss the identity and function of risk genes, the potential roles they have in pathogenesis and future research efforts.

    • Xiaojun Jiang
    •  & Tom H. Karlsen

  • Review Article |

    Many autoimmune diseases are known to occur alongside coeliac disease and, in some instances, patients see improvements in both if coeliac disease is diagnosed and treated. Shared genetic traits have been identified between coeliac disease and many of these forms of autoimmunity. In this Review, an overview is presented of the genetic and immunological features of coeliac disease, its overlap with other autoimmune diseases and implications for screening strategies.

    • Knut E. A. Lundin
    •  & Cisca Wijmenga

  • Review Article |

    Coeliac disease is common, but remains under-diagnosed, partly because it can present with extraintestinal symptoms that do not immediately enable an accurate diagnosis of the underlying disease. In this Review, Leffler and colleagues discuss the most common extraintestinal manifestations, including dermatitis herpetiformis, gluten ataxia, anaemia, osteoporosis and others, to raise additional awareness among clinicians.

    • Daniel A. Leffler
    • , Peter H. R. Green
    •  & Alessio Fasano

  • Review Article |

    Emerging evidence indicates that the gut microbiota might have a role in the development of coeliac disease. In this Review, Verdu and colleagues describe how alterations in the composition and function of the gut microbiota might influence coeliac disease pathogenesis, presenting the latest data from human and experimental studies.

    • Elena F. Verdu
    • , Heather J. Galipeau
    •  & Bana Jabri

  • News & Views |

    Patients with noncoeliac gluten sensitivity (NCGS) can experience a range of gastrointestinal and extraintestinal symptoms. A study has now demonstrated that gluten is independently associated with depression in patients with NCGS. NCGS-associated depression might share similar pathophysiological mechanisms to other neurological manifestations observed in gluten-related disorders, such as ataxia and encephalopathy.

    • Imran Aziz
    •  & Marios Hadjivassiliou

  • Review Article |

    Autoimmune pancreatitis (AIP) is a unique form of pancreatitis that is suspected to involve autoimmune mechanisms. Given that AIP responds dramatically to steroid therapy, it is important to distinguish it from pancreatic cancer. AIP may be one manifestation of IgG4-related sclerosing disease, which is a systemic disease in which IgG4-positive plasma cells and T lymphocytes extensively infiltrate various organs. Kamisawa and colleagues describe the clinical and pathophysiological features of AIP and IgG4-related sclerosing disease.

    • Terumi Kamisawa
    • , Kensuke Takuma
    •  & Tsuneo Sasaki

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