Celiac disease and endometriosis: what is the nexus?

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This paper reviews the potential link between celiac disease and endometriosis, exploring immunological factors like interleukin-18 and interferon-gamma.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This short article reviews evidence for an immunologic and epidemiologic “nexus” between celiac disease and endometriosis, focusing on shared immune pathways discussed across referenced studies. It highlights reports of increased endometriosis risk among women with celiac disease and summarizes additional work linking endometriosis to immune mediators such as IL-18 and interferon-γ, alongside broader associations between endometriosis and autoimmunity. A key limitation is that the piece is not an original study and does not provide new analyses, relying on heterogeneous findings from prior papers with varying populations and designs. Relevance to endometriosis: it explicitly centers on endometriosis risk in women with celiac disease (e.g., citing Stephansson et al., 2011) while also discussing immune markers like IL-18 in the endometriosis/adenomyosis literature. This paper is centrally about endometriosis — it addresses the proposed immunologic and epidemiologic links between endometriosis and celiac disease.

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References Green PH, Cellier C (2007) Celiac disease. N Engl J Med 357:1731–1743 Lettesjo H, Hansson T, Bergqvist A, Gronlund J, Dannaeus A (2005) Enhanced interleukin-18 levels in the peripheral blood of children with coeliac disease. Clin Exp Immunol 139:138–143 Salvati VM, Mac Donald TT, BajaJ-Elliott M, Borrelli M et al (2002) Interleukin 18 and associated markers of T helper cell type 1 activity in coeliac disease. Gut 50:186–190 Leon AJ, Garrote JA, Blanco-Quiros A, Calvo C et al (2006) Interleukin 18 maintains a long-standing inflammation in coeliac disease patients. Clin Exper Immunol 146:479–485 Brottveit M, Beitnes AC, Tollefsen S, Bratlie JE et al (2013) Mucosal cytokine response after short-term gluten challenge in celiac disease and non-celiac gluten sensitivity. AM J Gastoenterol 108:842–850 Dinarello CA, Novick D, Puren AJ, Fantuzzi G et al (1998) Overview of interleukin-18: more than an interferon-γ inducing factor. J Leukoc Biol 63:658–664 Bethun MT, Siegel M, Howles-Banerji S, Khosla C (2009) Interferon-γ released by gluten-stimulated celiac disease-specific intestinal T cells enhances the transepithelial flux of gluten peptides. J Pharmacol Exp Ther 329(2):657–668 Norris JM, Barriga K, Hoffenberg EJ, Taki I et al (2005) Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. JAMA 293:2343–2351 Stephansson O, Falconer H, Ludvigsson J (2011) Risk of endometriosis in 11.000 women with celiac disease. Hum Reprod 26(10):2896–2901 Aguiar FM, Melo SB, Galvao LC, Rosa-e-Silva JC et al (2009) Serological testing for celiac disease in women with endometriosis. A pilot study. Clin Exp Obstet Gynecol 36:23–25 Podgaec S, Jr Dias JA, Chapron C, de Oliveira RM et al (2010) TH1 and TH2 immune responses related to pelvic endometriosis. Rev Asoc Med Bras 56:92–98 Eisenberg VH, Zolti M, Soriano D (2012) Is there an association between autoimmunity and endometriosis? Autoimmun Rev 11:806–814 Sinaii N, Clearly SD, Ballweg ML, Nieman LK, Stratton P (2002) High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod 17:2715–2724 Oku H, Tsuji Y, Kashiwamura SI, Adachi S et al (2004) Role of IL-18 in pathogenesis of endometriosis. Hum Reprod 19:709–714 Hong-Yuan H, Hsing-Tse Y, She-Hung C, Chyi-Long L et al (2010) Eutopic endometrial interleukin-18 system mRNA and protein expression at the level of endometrial-myometrial interface in adenomyosis patients. Fertil steril 94:33–39 Chiang CM, Hill JA (1997) Localization of T cells, interferon-gamma and HLA-DR in eutopic and ectopic human endometrium. Gynecol Obstet Invest 43(4):245–250 Bhanothu V, Rozati R, Theophilus J (2013) Prevalence and polymorphism in interferon-γ Gene (CA) repeats with different stage of endometriosis. Am J Med Biol Res 1:1–5 Sundqvist J, Falconer H, Seddighzadeh M, Vidilazkaia A et al (2011) Endometriosis and autoimmune disease: association of susceptibility to moderate/severe endometriosis with CCL1 and HLA-DRB1. Fertil Steril 95:437–440 Marziali M, Venza M, Lazzaro S, Lazzaro A et al (2012) Gluten-free diet: a new strategy for management of painful endometriosis-related symptoms? Minerva Chir 67:499–504 Kumar A, Meena M, Begum N, Kumar N, Gupta RK et al (2011) Latent celiac disease in reproductive performance women. Fertil Steril 95:922–927 Naz RK, Butler A, Witt BR, Barad D, Menge AC (1995) Levels of interferon-gamma and tumor necrosis factor-alpha in sera and cervical mucus of fertile and infertile women: implication in infertility. J Reprod Immunol 29:105–117 Conflict of interest We warrant that there are no conflict of interest statements to declare. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Mormile, R., Vittori, G. Celiac disease and endometriosis: what is the nexus?. Arch Gynecol Obstet 288, 1197–1198 (2013). https://doi.org/10.1007/s00404-013-2928-3 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-013-2928-3

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endometriosis

MeSH descriptors

Celiac Disease Endometriosis Th1 Cells Celiac Disease Endometriosis Female Humans Inflammation Inflammation Inflammation Th1 Cells

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