Coeliac disease is a life-long condition in which ingestion of gluten, the water insoluble wheat gliadin and the prolamins in rye and barley, leads to chronic inflammation and damage of the small intestinal mucosa. The disease is multifaceted in nature with clinical presentation ranging from gastrointestinal manifestations to asymptomatic, silent and extraintestinal forms. It is widely accepted that dermatitis herpetiformis, a bullous skin disease, is induced by gluten. The term gluten refers to a whole set of proteins in the socalled endosperm, the nutritive tissue of the grain seed of wheat, rye, oats and barley. The alcohol-soluble polypeptides of gluten, the gliadins, are solely responsible for the toxic effects to the intestinal mucosa. More recent research revealed that gliadin peptides deamidated by tissue transglutaminase represent more specific B-cell epitopes than native peptides.
