Study identifies key immune structures in the gut that may drive coeliac disease

The team from the University of Oxford, supported by the NIHR Oxford Biomedical Research Centre (BRC), also found that many of these changes in the gut persisted despite treatment with a gluten-free diet, suggesting there may be an immune 'scar' in the gut, which could explain why some patients experience ongoing symptoms.

Coeliac disease is a common condition affecting around one in 100 people. Symptoms are triggered by exposure to gluten in the diet. Gluten is found in foods containing wheat, barley and rye.

However, we do not know why some people develop the disease and others do not, nor how the changes seen in the gut take place. Although symptoms improve on a gluten-free diet, this does not represent a cure.

In this study, published in Nature Immunology, researchers from the University’s Translational Gastroenterology and Liver Unit (TGLU), MRC Weatherall Institute of Molecular Medicine (MRC WIMM) and Centre for Human Genetics used gene sequencing methods called single cell and spatial transcriptomics to study how different cell types in the gut lining changed in adults and children with coeliac disease. 

This research showed that in coeliac disease, groups of different immune cells come together into organised structures in the gut lining. These structures may contain the key immune cells that recognise gluten and may act as the 'control centre' driving all the changes that we see in coeliac disease and as local ‘factories’ for the immune response.

Agne Antanaviciute, an MRC WIMM Computational Biologist who co-led the study, said:

Many people living with coeliac disease have problems with ongoing symptoms despite their best efforts at the gluten-free diet. This immune 'scar' in the gut lining that we have described could be contributing to their ongoing symptoms, and we hope that our study findings could lead to new treatments for our patients.

These findings show in detail how the different components of the gut respond together in coeliac disease – and offers new targets for therapy, as well as potentially a cure.

Read the full story on the NIHR Oxford BRC website: https://oxfordbrc.nihr.ac.uk/study-identifies-key-immune-structures-in-the-gut-that-may-drive-coeliac-disease/

Read the full paper here: https://www.nature.com/articles/s41590-025-02146-2

As well as the NIHR Oxford BRC, this research received funding from Coeliac UK, Beyond Celiac, Wellcome and Breakthrough T1D.