The immune and microbial homeostasis determines the Candida–mast cells cross-talk in celiac disease

Celiac disease (CD) is an autoimmune enteropathy resulting from an interaction between diet, genome, and immunity. Although many patients respond to a gluten -free diet, in a substantive number of individuals, the intestinal injury persists. Thus, other factors might amplify the ongoing in flammation. Candida albicans is a commensal fungus that is well adapted to the intestinal life. However, speci fic conditions increase Candida pathogenicity. The hypothesis that Candida may be a trigger in CD has been proposed after the observation of similarity between a fungal wall component and two CD -related gliadin T -cell epitopes. However, despite being implicated in intestinal disorders, Candida may also protect against immune pathologies highlighting a more intriguing role in the gut. Herein, we postulated that a state of chronic in flammation associated with microbial dysbiosis and leaky gut are favorable conditions that promote C. albicans pathogenicity eventually contributing to CD pathology via a mast cells (MC) -IL -9 axis. However, the restoration of immune and microbial homeostasis promotes a bene ficial C. albicans - MC cross -talk favoring the attenuation of CD pathology to alleviate CD pathology and symptoms.