Celiac disease is a genetically determined autoimmune disease characterized by inflammation of the mucosa caused by an intolerance to gluten, a protein found in wheat, rye and barley (Green et al.. 2007). The disease has a classic association with gastrointestinal symptoms such as abdominal pain and constipation and is said to affect approximately 1% of the population (Miśkiewicz et al. 2012). Often the disease is accompanied by weight loss, anemia, weakness and bone disease. Celiac disease has also been associated with reproductive dysfunctions in women, such as recurrent miscarriages, alternating menstrual cycles, and infertility (Sóñora et al. 2011). Reproductive dysfunction occurs when there is an abnormality in the reproductive organs that causes difficulty reproducing. In general, reproductive dysfunction is said to affect men and women equally. Women who suffer from reproductive dysfunction tend to experience complications during conception and pregnancy. The increased prevalence of celiac disease in women suffering from reproductive dysfunction has been studied. Unexplained infertility in women suffering from celiac disease has been described since the 1970s (Pellicano et al. 2007). Women suffering from celiac disease have a 2.5-3.5% higher rate of unexplained infertility than normal women (Pellicano et al. 2007). Women who suffer from celiac disease, whether treated or not, tend to have recurrent miscarriages and infertility (Ana Paula de Souza Machado et al. 2013). Low birth weight and shorter duration of breastfeeding have also been observed in women suffering from celiac disease (Green et al. 2003). The link between celiac disease and reproductive dysfunction in women has been studied, but there is no known mechanism for this association. Researchers have been trying to understand the mechanism linking celiac disease and reproductive dysfunction for many years. Studies have been conducted on the contents of sera from celiac patients, tissue transglutaminase (tTG) activity and genotype. When studying plasma from celiac patients, also known as serology, high amounts of specific (defined) IgA antibodies were observed (Sóñora et al. 2011). These antibodies react with tTG(define) and, although they are mainly located in the jejunum, they can also be found in the liver, muscles, brain and heart. tTG-specific antibodies can also affect enzyme activity, endothelial cell permeability, development of new blood vessels, cell differentiation, and cell proliferation. Tissue transglutaminase is a multifunctional enzyme that is expressed in most tissues and every cellular compartment.
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