Fasano Biologia E Genetica May 2026

Introduction: Redefining Autoimmunity For decades, autoimmunity was framed as a simple three-factor puzzle: a genetically susceptible host, an environmental trigger, and a dysfunctional immune system. Alessio Fasano , a Italian physician-scientist and pediatric gastroenterologist at Massachusetts General Hospital and Harvard Medical School, fundamentally rewrote this paradigm. His work integrated a fourth, often overlooked component: the intestinal barrier . By bridging biology (physiology of the gut mucosa) and genetics (HLA haplotypes and non-HLA genes), Fasano provided a unified molecular theory for the pathogenesis of celiac disease and, more broadly, of autoimmune disorders.

| | Evidence for zonulin involvement | |---------------|----------------------------------------| | Type 1 diabetes | Increased zonulin precedes autoantibodies (GAD, IA-2) in at-risk children | | Multiple sclerosis | Zonulin levels correlate with blood–brain barrier disruption | | Inflammatory bowel disease (Crohn’s, UC) | Elevated zonulin in active disease, regardless of genetics | | Autism spectrum disorder | Subgroup with GI symptoms shows increased zonulin and detectable gluten-related antibodies | | Celiac disease (active) | Zonulin levels normalize after gluten-free diet | fasano biologia e genetica