CELIAC-DISEASE - A REVIEW OF THE CAUSATIVE AGENTS AND THEIR POSSIBLE MECHANISMS OF ACTION

This review outlines the main theories for the aetiology of coeliac di sease and presents in more detail the work carried out in an attempt t o define the nature of the toxins in wheat gluten. This includes the r esults of work with synthetic peptides and a discussion of the various assays used. Evidence is presented for an enzyme deficiency in coelia c disease which leads to abnormally high concentrations of certain pep tides in the small bowel. These peptides can bring about damage by dir ect toxic action and by immunological mechanisms. Investigations of ac tivity of synthetic peptides based on the structure of A-gliadin appea r to be making good progress and point to certain regions of that mole cule as being responsible for toxicity. Certain key sequences of amino acids appear to be of fundamental importance to these studies.