Untangling the Gluten-Driven Chain Reaction Behind Celiac Gut Damage

A comprehensive review of 100+ studies maps how genetic risk, the TG2 enzyme, immune cells (including intraepithelial lymphocytes), stromal cell signals, and gut bacteria interact to amplify gluten-triggered immune damage to the gut lining. This multi-factor cascade helps explain why only some genetically predisposed people develop celiac disease and could guide future therapies beyond a gluten-free diet.