Researchers at the University of Oxford have used advanced gene sequencing techniques to uncover new insights into coeliac disease, revealing an “immune scar” in the gut that may explain persistent symptoms despite adherence to a strict gluten-free diet.
Funded by Coeliac UK, the study explored how immune cells interact within the gut lining, identifying organised immune structures that may act as control centres driving inflammation and tissue damage.
Using single-cell and spatial transcriptomics, the team mapped gene activity in individual gut cells from both adults and children with coeliac disease. This allowed them to pinpoint where specific immune responses occur and how they affect surrounding cells. The research showed that even in people who strictly avoid gluten, immune cell clusters continue to damage epithelial cells responsible for nutrient absorption.
These findings suggest that coeliac disease may leave a lasting imprint on the gut’s immune landscape, contributing to ongoing symptoms and rapid relapse after accidental gluten exposure. The study opens new avenues for treatment by targeting the signalling pathways between immune cells to reduce inflammation.
Published in Nature Immunology, this research marks a significant step toward developing therapies beyond the gluten-free diet, which remains restrictive and insufficient for many people with coeliac disease.
