MetaTOC stay on top of your field, easily

Despite Sequence Homologies to Gluten, Salivary Proline-Rich Proteins do not Elicit Immune Responses Central to the Pathogenesis of Celiac Disease

, , , , , , ,

AJP Gastrointestinal and Liver Physiology

Published online on

Abstract

Background: Celiac disease (CD) is an inflammatory disorder triggered by ingested gluten, causing immune-mediated damage to the small-intestinal mucosa. Gluten proteins are strikingly similar in amino acid composition and sequence to proline-rich proteins (PRPs) in human saliva. Based on this feature and their shared destination in the gastro-intestinal tract, we hypothesized that salivary PRPs may modulate gluten-mediated immune responses in CD. Methods: Parotid salivary secretions were collected from CD patients, refractory CD patients, non-CD patients with functional gastrointestinal complaints (GI), and healthy controls (HC). Structural similarities of PRPs with gluten were probed with anti-gliadin antibodies. Immune responses to PRPs were investigated towards CD patient-derived peripheral blood mononuclear cells and in a humanized transgenic HLA-DQ2/DQ8 mouse model for CD. Results: Anti-gliadin antibodies weakly cross-reacted with salivary amylase but not with PRPs. Likewise, the R5 antibody, recognizing potential antigenic gluten epitopes, showed negligible reactivity to salivary proteins from all groups. Inflammatory responses in PBMCs were provoked by gliadins while responses to PRPs were similar to control levels, and PRPs did not compete with gliadins in immune stimulation. In vivo, PRP peptides were well-tolerated and non-immunogenic in the transgenic HLA-DQ2/DQ8 mouse model. Conclusions: Although structurally similar to dietary gluten, salivary RPRs were non-immunogenic in CD patients and in a transgenic HLA-DQ2/DQ8 mouse model for CD. It is possible that salivary PRPs play a role in tolerance induction to gluten early in life. Deciphering the structural basis for the lack of immunogenicity of salivary PRPs may further our understanding of the toxicity of gluten.