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Dietary gluten and the development of type 1 diabetes.
[severe combined immunodeficiency]
Gluten
proteins
differ
from
other
cereal
proteins
as
they
are
partly
resistant
to
enzymatic
processing
in
the
intestine
,
resulting
in
a
continuous
exposure
of
the
proteins
to
the
intestinal
immune
system
.
In
addition
to
being
a
disease-initiating
factor
in
coeliac
disease
(
CD
)
,
gluten
intake
might
affect
type
1
diabetes
development
.
Studies
in
animal
models
of
type
1
diabetes
have
documented
that
the
pathogenesis
is
influenced
by
diet
.
Thus
,
a
gluten-free
diet
largely
prevents
diabetes
in
NOD
mice
while
a
cereal-based
diet
promotes
diabetes
development
.
In
infants
,
amount
,
timing
and
mode
of
introduction
have
been
shown
to
affect
the
diabetogenic
potential
of
gluten
,
and
some
studies
now
suggest
that
a
gluten-free
diet
may
preserve
beta
cell
function
.
Other
studies
have
not
found
this
effect
.
There
is
evidence
that
the
intestinal
immune
system
plays
a
primary
role
in
the
pathogenesis
of
type
1
diabetes
,
as
diabetogenic
T
cells
are
initially
primed
in
the
gut
,
islet-infiltrating
T
cells
express
gut-associated
homing
receptors
,
and
mesenteric
lymphocytes
transfer
diabetes
from
NOD
mice
to
NOD
/
severe
combined
immunodeficiency
(
SCID
)
mice
.
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
and
further
studies
should
be
initiated
to
clarify
whether
a
gluten-free
diet
could
prevent
disease
in
susceptible
individuals
or
be
used
with
newly
diagnosed
patients
to
stop
disease
progression
.
Diseases
Validation
Diseases presenting
"newly diagnosed patients"
symptom
erythropoietic protoporphyria
severe combined immunodeficiency
waldenström macroglobulinemia
werner syndrome
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