Novel players in coeliac disease pathogenesis: role of the gut microbiota

Key PointsThe intestinal microbiota coexists with its host in a continuum between homeostasis and pathogenicity; the upper gastrointestinal tract harbours a gut microbiota that is affected compositionally and metabolically by food componentsCoeliac disease is a chronic immune-mediated enteropathy caused by dietary gluten in genetically susceptible individualsThe role of microbial factors in coeliac disease pathogenesis has been suggestedAlthough clinical studies demonstrate that microbial changes are associated with coeliac disease, the individual microbes involved and underlying mechanisms remain elusiveEmerging data in gnotobiotic models indicate that the intestinal microbiota has a complex modulatory role in host immune responses to glutenA deeper understanding of the precise role of microbes in coeliac disease pathogenesis will aid in the development of microbiota-modulating strategies, such as probiotics, to prevent or help treat the disease