Mechanism behind tooth enamel disorder in coeliac disease


Kuopio, Finland: Celiac disease is known to adversely affect oral health, but the underlying mechanisms are not fully understood. A recent study found a link between disorders of enamel development, common in patients with certain autoimmune diseases, and autoantibodies against proteins involved in enamel formation.

According to the Celiac Disease Foundation, celiac disease affects approximately 1% of the population and is the most common genetic food intolerance worldwide. The prevalence is higher in children than in adults. Although initially reported from predominantly white countries, it is now reported in other parts of the world.

In addition to gastrointestinal symptoms, an often overlooked aspect of celiac disease is its impact on oral health. Previous research has identified a link between celiac disease and a variety of oral health problems, including delayed tooth eruption, enamel disease, and oral aphthous ulcers. These oral manifestations can serve as valuable indicators for early screening of disease, so dental professionals must be aware and refer patients to general practitioners for follow-up.

This international collaborative study involves researchers from the Czech Republic, Israel, Norway, Hungary and Finland. The study included 48 adults and 21 children with celiac disease, as well as 28 patients with autoimmune polyglandular syndrome type 1 (APS-1), the University of Eastern Finland reported in a press release.

The small intestinal protein transglutaminase 2 (TGM2) plays a key role in the development of celiac disease by altering the gluten content of the diet. This modification prompts the immune system of celiac disease patients to produce antibodies.

Until now, it was thought that the oral manifestations of celiac disease were primarily caused by malabsorption caused by intestinal inflammation. However, researchers found that these antibodies bind to proteins responsible for enamel formation, causing disease. This is caused by the protein enamel, which displays similar antibody binding sites to the protein TGM2.

The study, titled “APS-1 and Imperfect Autoimmune Amelogenesis in Celiac Disease Patients,” was published online on November 22, 2023 in naturebefore incorporating into the question.

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