title: Enhanced interleukin-18 levels in the peripheral blood of children with coeliac disease.
abstract: Coeliac disease (CoD) is a small intestinal disorder characterized by villous atrophy, crypt cell hyperplasia and an increased production of T helper cell type 1 (Th1) cytokines. Interleukin (IL)-18 is a pro-inflammatory cytokine that has a crucial role in maintaining the Th1 response. In this study, the serum levels of IL-18 were measured in children with CoD or other gastrointestinal diseases in order to evaluate the possibility of using IL-18 as a disease activity marker. IL-18 levels were higher in samples from CoD patients [median 443 pg/ml (148-885)] compared to healthy controls [median 205 pg/ml (11-379)], P <0.05. In contrast, the levels of IL-18 were not enhanced significantly in the serum from patients with inflammatory bowel disease (IBD) [median 324 pg/ml (207-546)] or in the disease control group [median 303 pg/ml (2-689)]. In CoD patients, after 2 weeks of gluten challenge (GC), serum IL-18 was unchanged [median 268 pg/ml (59-458)] compared to patients on a gluten-free diet [median 220 pg/ml (53-600)], while IL-18 was increased after 12 weeks of GC [median 551 pg/ml (94-952)], P <0.01. The IL-18 levels correlated with IgA anti-transglutaminase antibody levels (rs=0.59, P=0.016) in serum from untreated CoD patients, and IL-18 also followed the degree of small intestinal villous atrophy in 12 out of 19 CoD patients. Our results support the view that serum IL-18 concentrations in children with CoD follow disease activity, suggesting a role for IL-18 in the induction of an inflammatory Th1-response after gluten exposure.
authors.affiliation: Department of Gastrointestinal Research, Pharmacia Diagnostics, Uppsala, Sweden. helene.lettesjo@diagnostics.com
authors.forename: H
authors.initials: H
authors.lastname: Lettesjö
authors.forename: T
authors.initials: T
authors.lastname: Hansson
authors.forename: A
authors.initials: A
authors.lastname: Bergqvist
authors.forename: J
authors.initials: J
authors.lastname: Grönlund
authors.forename: A
authors.initials: A
authors.lastname: Dannaeus
mesh_terms: D000293:Adolescent; D001284:Atrophy; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D018753:Diet, Protein-Restricted; D005260:Female; D005983:Glutens / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000276:immunology; D020382:Interleukin-18 / Q000097:blood*; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A; D020382:Interleukin-18; D005983:Glutens; D011503:Transglutaminases