Comment by nibstwo

I have Celiac. Unfortunately immunotherapy is not currently done in a way that would make much of a difference for us. Celiac is typically an autoimmune response to Gliadin protein as a result of human leukocyte activation genes HLA-DQ2.2/2.5 or HLA-DQ8. In either case, it is happening at the cellular level for every cell that comes into contact with the protein. The intestines are hard hit mostly because they spend the longest time with exposure. I found for the first year or so I simply could not eat anything made by a restaurant or friend because of cross contamination. My resilience went up over time though, it takes a few years for inflammatory activation to come back down to a subclinical level even if the gut repairs in 3-6 months. Gut bacteria change in response to all the immune activity, but damping the immune response would not necessarily fix the issue of the protein destroying the cells it comes into contact with. The immune response is therefore not entirely autoimmune in nature but necessary to protect the cells. The vili are being destroyed directly, essentially. You could develop a drug that would dampen the immune response (I think a few others posted links) but you could not realistically get to a point where you can eat gluten. The antigen will always destroy your cells, autoimmune response or not. Sensitivity depends on how many (one or two) of the HLA genes you have that react with gluten. I have one out of two so my reactions are less severe (only 2-3 days with symptoms). If you have both Celiac HLA genes, it will always and consistently harm you.