Serum cytokine pattern in young children with screening detected coeliac disease.

Clinical and experimental immunology. 2015;179(2):230-5
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Plain language summary

Coeliac disease (CD) is an autoimmune disorder characterised by inflammation in the small bowel after ingesting gluten. Many patients may be asymptomatic and clinically silent, prolonging their diagnosis and treatment. This may put them at risk for long-term complications due to chronic systemic inflammation. Circulating cytokines indicate inflammatory activity in the body and have been shown to be elevated in patients with CD. The aim of this study was to measure the levels of serum cytokines in 26 3-year-old children with CD, both at the time of diagnosis and after starting a gluten-free diet. The findings of this study showed that young children with CD demonstrated elevated levels of serum cytokines at the time of diagnosis. After maintaining a gluten-free diet, many cytokine levels decreased. Based on this study, the authors’ conclude that systemic inflammation due to undiagnosed disease in young children may contribute to long-term complications associated with chronic inflammation, and should be accounted for when screening for the disease.

Abstract

Coeliac disease is an autoimmune disease characterized by inflammation localized to the small bowel, but less is known about systemic signs of inflammation. The aim was to measure cytokines of the T helper 1 (Th1) and T helper 2 (Th2) cell patterns in children with screening-detected coeliac disease before and after treatment with a gluten-free diet. Serum samples selected before and after the start of a gluten-free diet from 26 3-year-old children diagnosed with biopsy-proven coeliac disease and from 52 matched controls were assayed in an multiplex enzyme-linked immunosorbent assay (ELISA) for the 10 cytokines: interferon (IFN)-γ, interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-8, IL-10, IL-12p70, IL-13 and tumour necrosis factor (TNF)-α. Among Th1 cytokines, IFN-γ and IL-12p70 were elevated significantly in children with coeliac disease compared to controls (P < 0.001 and P = 0.001, respectively). Similar findings were demonstrated for the Th2 cytokines IL-5 (P < 0.001), IL-10 (P = 0.001) and IL-13 (P = 0.002). No difference in cytokine levels between the two groups was found for TNF-α, IL-1β, IL-2, IL-4 and IL-8. After gluten-free diet, levels of IL-5, IL-12 and IL-10 decreased significantly (P < 0.001, P = 0.002 and P = 0.007) and IFN-γ levels were reduced (P = 0.059). Young children with coeliac disease detected by screening demonstrate elevated levels of serum cytokines at time of diagnosis. A prolonged systemic inflammation may, in turn, contribute to long-term complications known to be associated with untreated coeliac disease.

Lifestyle medicine

Patient Centred Factors : Mediators/Cytokines
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Blood
Bioactive Substances : Coeliac disease ; ELISA ; Gluten ; Gluten-free diet ; Screening

Methodological quality

Allocation concealment : Not applicable

Metadata

Nutrition Evidence keywords : Coeliac disease ; ELISA ; Gluten ; Gluten-free diet ; Screening