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Gluten exposure rapidly increases intestinal permeability within hours to a few days, primarily through gliadin, which activates toll-like receptor 2 and 4 (TLR2 and TLR4) in macrophages, leading to NF-B overexpression and the release of pro-inflammatory cytokines such as TNF- ( , IFN- , and IL-15 exacerbate this dysfunction, creating a vicious cycle of barrier disruption and inflammation ( The gut microbiota represents another critical component of the pathophysiological cascade in CD

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[DOI] [PMC free article] [PubMed] 114.Henry JA, Jeffreys KJ, Dawling S