The immune and microbial homeostasis determines theCandida–mast cells cross-talk in celiac disease

Abstract

Celiac disease (CD) is an autoimmune enteropathy resulting from an interaction between diet, genome, and immunity. Although many patients respond to a gluten-free diet, in a substantive number of individuals, the intestinal injury persists. Thus, other factors might amplify the ongoing inflammation.Candida albicansis a commensal fungus that is well adapted to the intestinal life. However, specific conditions increaseCandidapathogenicity. The hypothesis thatCandidamay be a trigger in CD has been proposed after the observation of similarity between a fungal wall component and two CD-related gliadin T-cell epitopes. However, despite being implicated in intestinal disorders,Candidamay also protect against immune pathologies highlighting a more intriguing role in the gut. Herein, we postulated that a state of chronic inflammation associated with microbial dysbiosis and leaky gut are favorable conditions that promoteC. albicanspathogenicity eventually contributing to CD pathology via a mast cells (MC)-IL-9 axis. However, the restoration of immune and microbial homeostasis promotes a beneficialC. albicans–MC cross-talk favoring the attenuation of CD pathology to alleviate CD pathology and symptoms.