Why Is Celiac Disease on the Rise? The Answer Is in The Gut Microbiome
Gluten-free food is everywhere these days. Some scoff at “going gluten-free,” believing it’s a trendy diet choice, when it may actually be a necessary diet modification for some people. Gluten can wreak havoc on the body in those with a gluten sensitivity or intolerance, and it’s downright dangerous for those with celiac disease.
Gluten is a family of proteins found in grains such as wheat, barley, and rye. For those who are sensitive or intolerant to gluten, it can cause debilitating symptoms. In celiac disease, gluten can cause the immune system to attack the lining of the gut leading to severe damage to the gut lining resulting in decreased nutrient absorption and intestinal permeability, which is a scientific way of saying – gluten can put holes in the gut of those with celiac disease – yikes! 1 When your gut lining is compromised, harmful substances that shouldn’t be allowed to pass through the gut lining can pour across the gut membrane, stimulating the immune system and entering the bloodstream.
As you can imagine, a leaky gut isn’t great for your body. Leaky gut leads to widespread inflammation, a cascade of health problems, and eventually autoimmune disease. Celiac disease is an autoimmune condition where the immune system mistakes gluten for a harmful pathogen and launches an attack against the gluten and your own intestinal cells resulting in inflammation, gastrointestinal issues, and eventually malnutrition. 1
Because the gut microbiome is critical in training and strengthening the immune system, researchers think there could be a link between gut microbes and the onset and progression of celiac disease. There are even specific bacteria that have been associated with celiac disease.
16 Symptoms of Celiac Disease
Celiac disease causes damage to the small intestine, which differs from gluten sensitivity, where there is no damage – though initially they may have similar symptoms. 2 Symptoms of celiac disease include:
Although these are uncomfortable and sometimes debilitating symptoms, people with celiac disease eventually experience such damage to their gut lining that they don’t absorb nutrients properly. A lack of nutrients can result in:
Tingling in hands and feet
When celiac disease progresses to the point where the symptoms aren’t gut related, it can be confusing for those affected. However, celiac disease is definitely a condition primarily of the gut – one that includes dysbiosis (gut microbiome imbalance) and immune system dysfunction.
So what exactly do the trillions of microbes living in your gut have to do with celiac disease? A whole heck of a lot.
Celiac Disease and The Gut Microbiome
The role of the gut microbiome in autoimmunity is undeniable and more clear than ever before. The gut is approximately 200 square meters, surrounded by 70-80% of our immune cells, and is home to so many microbes that they outnumber the cells of our bodies.
Research has found significant alterations in the gut microbiome of those with celiac disease.
Recent findings pinpoint species of gut microbiota may activate the inflammatory pathways that trigger celiac reactions. Another interesting connection between gut microbes and celiac patients is that they have less beneficial microbial species and more pathogenic species compared to those without the disease. 4
The strong connection between celiac disease and the gut microbiome has provided scientists a new path to follow for developing better treatment options for those who are celiac. Could we find and manipulate exact microbial interactions to help those with celiac disease? The future of gut microbiome research is hopeful.
What Bacteria Causes Celiac Disease?
We are often asked, “What bacteria causes celiac disease?” While we wish it was that simple, the body and gut microbiome have a highly sophisticated relationship. So, there isn’t one bacteria we can point to and say, “This bacteria causes celiac disease.” Your gut microbiome is healthiest when it is balanced, with all your microbes living synergistically with one another.
Several studies report that altered composition and function of gut microbiota can trigger or contribute to the progression of celiac disease. 5 Specifically within the gut microbiome, there are a few patterns that have come to light:
Decrease in Bifidobacterium spp 8
Increase in Proteobacteria spp 6
Increase in Clostridium leptum 8
A decreased microbial diversity and altered gut microbiome function contributes to a decrease in protective short-chain fatty acids as well 9
Overall, it appears that those with celiac disease may have a distinct gut microbiome composition – meaning it’s possible that manipulating the gut microbiome could play an important role in new therapies. 10
Nearly all of the available research on gut microbiome composition and celiac disease was done with 16S sequencing, which can only see on a genus level. With newer technologies like Viome’s RNA sequencing, we can now see microbes on a strain level and what the microbes are actually doing. This new information could contribute to new options for those with celiac disease.
Another interesting finding linking celiac disease and the gut microbiome has been observed in animal studies looking at the DQ8 gene. The DQ8 gene seems to be present in most individuals with celiac disease. In a study comparing the gut microbiome of mice expressing DQ8 to those lacking the gene, found that DQ8 positive mice had increased Proteobacteria bacteria. The more Proteobacteria bacteria that was present in the mouse’s microbiome, the more severe their reaction to gluten was. On the other hand, when Proteobacteria bacteria was reduced in DQ8 positive mice, the mice had a lesser reaction to gluten. 11
Although this is an animal study, it does carry exciting implications – What if we could reduce the impact of gluten on a person with celiac disease by adding or subtracting certain microbes?
Why is Celiac Disease on the Rise?
Compared to our ancestors, we have decreased microbial diversity – due to antibiotics, increased c-sections, low food diversity, moving to cities, and more. Could widespread alterations in the gut microbiome be a major contributor to the rise in celiac disease? Many scientists believe so, and this study reinforces that theory.
As Dr. Verdu, who performed the DQ8 mouse study, says, “Importantly, our data argues that the recognized increase in celiac disease prevalence in the general population over the last 50 years could be driven, at least in part, by perturbations in intestinal microbial ecology. Specific microbiota-based therapies may aid in the prevention or treatment of celiac disease in subjects with moderate genetic risk.” 12
It seems as though celiac disease appeared all of a sudden. A condition that was practically unknown to our grandparents is suddenly everywhere.. 13 It’s estimated that up to 1% of the American population is thought to have celiac disease (many are undiagnosed) – this is a staggering 3 million people. 2 It’s time we had better solutions.
The Gut Microbiome – A New Approach to Celiac Disease
The gut microbiome shows great promise for guiding the development of novel treatments for celiac disease. At Viome we are thrilled to watch this area of science unfold. We also promise to keep you up-to-date in current developments.
There’s a common misconception we’d like to address when it comes to celiac disease – there is no “best probiotic” for celiac disease. So, be wary of anyone claiming that a probiotic can correct dysbiosis related to celiac disease. Probiotics can be beneficial in many diseases, and maybe someday science will develop a probiotic specific to target celiac-associated microbes.
Until then, the best approach you can take to reduce the impact of celiac disease on your life is by adopting a gluten-free diet. You can also take the Viome test to gain deep insights into your gut microbiome.
Through Viome’s revolutionary RNA sequencing technology and analysis by expert trained Artificial Intelligence, you’ll find out exactly how to eat for your gut microbiome and start your journey towards reduced inflammation and improved health. The app makes knowing exactly which foods will benefit you a breeze.
**Viome is not claiming to cure any disease. We are a health and wellness company determined to help you find the diet perfect for you and your gut microbiome.