Serum soluble interleukin-2 receptor, interleukin-6, and tumor necrosis factor-alpha levels in children with celiac disease: response to treatment.
OBJECTIVE
T-cell mediated immune response to dietary gluten and cytokines release are important for the enteropathy seen in celiac disease. We investigated the serum levels of soluble interleukin-2 receptor, interleukin-6, and tumor necrosis factor-alpha in celiac children before and after gluten exclusion.


METHODS
Cytokine levels were determined using enzyme immunoassay in serum from 12 untreated celiac patients, 16 treated celiac patients on a gluten-free diet for at least two years, and from 26 control children. Eight of 12 untreated patients were also investigated at 6 and 12 months after gluten exclusion. Serum IgA antiendomysium antibodies were also assayed by indirect immunofluorescence.


RESULTS
Soluble interleukin-2 receptor and interleukin-6 levels were significantly increased in untreated celiac patients compared with treated and control children. There was no difference in the tumor necrosis factor-alpha levels between the groups. Soluble interleukin-2 receptor levels were the only ones significantly decreased at 12 months after gluten exclusion. However, soluble interleukin-2 receptor and interleukin-6 levels at 12 months were significantly higher compared with controls. Antiendomysium antibodies had a diagnostic sensitivity of 100% and the titers decreased significantly after 12 months of gluten exclusion. A significant positive correlation was found between antiendomysium antibody titers with both soluble interleukin-2 receptor and interleukin-6 values.


CONCLUSIONS
The serum soluble interleukin-2 receptor and interleukin-6 levels may be used as a noninvasive measure of celiac disease activity and response to treatment.
Romaldini
Ceres C
CC
Department of Pediatrics, Faculty of Medicine, University of São Paulo, Brazil. jhroma@netpoint.com.br
Barbieri
Dorina
D
Okay
Thelma S
TS
Raiz
Roberto
R
Cançado
Eduardo L R
EL
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005903:Gliadin / Q000276:immunology; D005983:Glutens / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D015375:Receptors, Interleukin-2 / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis* / Q000378:metabolism
D001323:Autoantibodies; D007070:Immunoglobulin A; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D005983:Glutens; D005903:Gliadin