Celiac disease: Prevalence, diagnosis, pathogenesis and treatment

Table 5 The most important factors contributing to the development of celiac disease[86] (printed with permission)

Factors contributing to the onset of celiac disease	Mechanism
Gluten	Elicit T cell responses
	Induces cytokine production and intestinal lesion
Age of introduction of gluten	Weak gut immune during early childhood
HLA-DQ2 or HLA-DQ8	Gluten presentation
MYO9Bo	Increased permeability of the intestine
Pro-autoimmune genetic background	Shift in Th1/Th2 balance towards Th1
Viral infections	Defect in generation of active tolerance (e.g., regulatory T cells)
	IFN production
Tissue damage	Tissue damage
	Increased level of tTG
	Danger signals
Early termination of breastfeeding	Decreased protection against infections
Gender	Hormone-related pro-autoimmune status

Th1: T helper 1; Th2: T helper 2; tTG: Tissue transglutaminase; HLA: Human leukocyte antigen; IFN: Interferon.