CLINICAL RESEARCH The Gluten Response in Children With Celiac Disease Is Directed Toward Multiple Gliadin and Glutenin Peptides

sponses in HLA-DQ2 positive adult celiac disease (CD) patients are directed to an immunodominant -gliadin (GLIA) peptide that requires deamidation for T-cell rec-ognition. The aim of the current study was to determine which GLU peptide(s) are involved early in disease. Methods: We have characterized the GLU-specific T-cell response in HLA-DQ2 positive children with recent onset CD. Results:We found that 50 % of these patients do not respond to the -GLIA peptide but to a diverse set of GLIA and glutenin (GLT) peptides, including 6 novel epitopes. Moreover, individual patients respond to dis-tinct (combinations of) GLU peptides. T-cell cross-reac-tivity toward homologous GLIA and GLT peptides was observed, which might play a role in the initial spreading of the GLU-specific T-cell response. Although all pediatri