Immune response of the small intestinal mucosa in children with celiac disease - Impact of two environmental factors, resident microbiota and oats

iii Populärvetenskaplig sammanfattning på svenska v Abbreviations list viii List of papers in the thesis ix 1 Introduction 1 1.1 General overview of the immune system 1 1.2 Lymphocytes 2 1.2.1 B-lymphocytes 2 1.2.2 T-lymphocytes 2 1.2.2.1 Extrathymic T-cell maturation 4 1.2.3 T-helper cells 5 1.2.4 Regulatory T-cells 6 1.2.5 Natural killer T-cells 7 1.2.6 γδT-cells 7 1.2.7 Cytotoxic T-cells 8 1.3 Lymphocytes of the innate immune system 9 1.3.1 NK-cells 9 1.3.2 Innate lymphoid cells 11 1.4 Antigen presenting cells 11 1.5 Cytokines and chemokines 12 1.6 The human intestine 16 1.6.1 Mucosal immunology 16 1.6.2 Intraepithelial lymphocytes 18 1.6.3 Lamina propria Lymphocytes 19 1.6.4 Intestinal epithelial cells 19 1.6.5 The human gut microbiota 20 1.7 Celiac disease 22 1.7.1 Clinical features 22 1.7.2 Diagnosis 23 1.7.3 Genetic predisposition 24 1.7.4 Environmental factors 25 1.7.4.1 The Swedish epidemic of celiac disease 26 1.7.5 Gluten and the immune response 27 1.7.6 Treatment 28 2 Aims 31 3 Clinical material and methods 32 3.1 Patient characteristics 32 3.2 Biopsies 32 3.3 Cell isolation 32