Clinical symptoms and basis of diagnostics

Coeliac disease (CD) and Dermatitis Herpetiformis (DH) are autoimmune diseases with known environmental trigger and a strong genetic component. The external trigger is ingested wheat gluten or related proteins from rye, barley and possibly oats. CD is a multigenic disorder with a strong HLA association. HLA-DQ2 and DQ8 confer susceptibility together with as yet unidentified gene loci. Expression of HLA-DQ2 and DQ8 molecules that present gliadin-derived peptides to CD4 T cells is necessary but not sufficient to develop CD.