In the normal small intestine, intact intercellular tight junctions act as a barrier to antigens such as gluten.
Similar results were found for dry gluten (data not shown).
Non-compliance with regard to the gluten-free diet is the most common cause of failure to respond to diet.
This reflects the interaction between genetic predisposition and ingestion of gluten-containing grains necessary to precipitate the disease.
It is only recently that the deleterious part of gluten has been identified and a method developed for the measurement of gluten-antibodies in the blood.
The main source of gluten is wheat, but the prolamins in rye and barley are also toxic and must be avoided.
A rechallenge with gluten is perhaps unnecessary in the elderly.
Compliance is aided by the frequent rapid symptomatic response to gluten withdrawal.
