title: Serum IL-8 in patients with dermatitis herpetiformis is produced in response to dietary gluten.
abstract: Patients with dermatitis herpetiformis (DH) have a gluten-sensitive enteropathy and while on gluten-containing diets have elevated levels of serum IL-8. We hypothesized that the mucosal immune response to gluten is responsible for the elevated serum IL-8. Six DH patients were studied while on a gluten-free diet (GFD), whereas four continued on a normal diet. Patients were followed for a mean 2.2 years and serum IL-8 was analyzed. Small bowel biopsies from five DH patients on normal diets, two DH patients on GFD, and six subjects with no small bowel abnormalities were analyzed for IL-8 mRNA. Serum IL-8 levels normalized in five of six patients on GFD and decreased in one, whereas serum IL-8 levels showed no statistically significant change in DH patients on normal diets. Small bowel biopsies from DH patients on normal diets had increased expression of IL-8 mRNA compared to normal subjects, whereas patients on a GFD showed no significant increase in small bowel mRNA. No significant IL-8 mRNA was detected in normal skin biopsies from patients with DH. These observations suggest that the IL-8 in the serum of patients with DH originates from the small bowel as a mucosal immune response to gluten ingestion.
authors.affiliation: Division of Dermatology, Department of Medicine, Duke University Medical Center, Durham VA Medical Center, Durham, North Carolina 27710, USA. Hall0009@mc.duke.edu
authors.forename: Russell P
authors.initials: RP
authors.lastname: Hall
authors.forename: Keith M
authors.initials: KM
authors.lastname: Benbenisty
authors.forename: Clinzo
authors.initials: C
authors.lastname: Mickle
authors.forename: Fumiko
authors.initials: F
authors.lastname: Takeuchi
authors.forename: Robert D
authors.initials: RD
authors.lastname: Streilein
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy; D003874:Dermatitis Herpetiformis / Q000097:blood*; D004032:Diet; D005260:Female; D005983:Glutens / Q000378:metabolism*; D006801:Humans; D007070:Immunoglobulin A / Q000737:chemistry; D016209:Interleukin-8 / Q000097:blood* / Q000378:metabolism; D007421:Intestine, Small / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000378:metabolism
chemical_list: D007070:Immunoglobulin A; D016209:Interleukin-8; D012333:RNA, Messenger; D005983:Glutens