Celiac disease (CD) is a chronic autoimmune disorder driven by both genetic and environmental
factors, with the HLA DQ2/DQ8 genotypes playing a central role in its development.
Despite the genetic predisposition, only a small percentage of individuals carrying
these genotypes develop the disease. Gluten, a protein found in wheat, rye, and barley,
is the primary environmental trigger, but other factors, such as the intestinal microbiota,
may also contribute to disease progression. While the gluten-free diet (GFD) remains
the cornerstone of treatment, many CD patients experience persistent inflammation
and gut dysbiosis, leading to ongoing symptoms and complications. This chronic inflammation,
which impairs nutrient absorption, increases the risk of malnutrition, anemia, and
other autoimmune disorders. Recent studies have identified an altered gut microbiota
in CD patients, both on and off the GFD, highlighting the potential role of the microbiota
in disease pathogenesis. An emerging area of interest is the supplementation of n-3
polyunsaturated fatty acids (PUFAs), known for their anti-inflammatory properties,
as a potential therapeutic strategy. n-3 PUFAs, found in fish oil and certain plant
oils, modulate the immune cell function and cytokine production, making them a promising
intervention for controlling chronic inflammation in CD. This review explores the
current understanding of n-3 PUFAs’ effects on the gut microbiota’s composition and
inflammation in CD, with the goal of identifying new avenues for complementary treatments
to improve disease management.
