Serum cytokine elevations in celiac disease: association with disease presentation.
Celiac disease (CD) is an autoimmune disorder that is triggered by an immune response to gluten in genetically predisposed individuals. Although considered a primary gastrointestinal disease, CD is now known to have widespread systemic manifestations. We attempted to define the nature and role of systemic cytokine levels in the pathophysiology of CD. Multiplex cytokine assays were performed on four different groups of adult patients; patients with active CD (ACD), patients on a gluten-free diet (GFD) with positive TTG IgA antibodies, patients on a GFD with negative antibodies, and those with refractory CD (RCD). The results were compared with values in healthy adult controls. Patients with active CD and those on GFD with positive antibodies had significantly higher levels of proinflammatory cytokines, such as interferon-gamma, interleukin (IL)-1beta, tumor necrosis factor-alpha, IL-6 and IL-8, and also T(h)-2 cytokines such as IL-4 and IL-10, compared with normal controls and patients on GFD without antibodies. Interestingly patients on GFD for less than 1 year had significantly higher levels of both proinflammatory cytokines and T(h)2 cytokines compared with the patients on GFD for more than 1 year. In addition, a statistically significant correlation between levels of TTG IgA titers and serum levels of T(h)-2 cytokines IL-4 (p < 0.001), IL-10 (p < 0.001) and inflammatory cytokines such as IL-1alpha (p < 0.001), IL-1beta (p < 0.005), and IL-8 (p < 0.05) was observed.
Manavalan
John Sanil
JS
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Hernandez
Lincoln
L
Shah
Jayesh Girish
JG
Konikkara
John
J
Naiyer
Afzal Jamal
AJ
Lee
Anne Roland
AR
Ciaccio
Edward
E
Minaya
Maria Theresa
MT
Green
Peter H R
PH
Bhagat
Govind
G
D000328:Adult; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology; D016207:Cytokines / Q000097:blood* / Q000276:immunology*; D055050:Diet, Gluten-Free; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology; D011503:Transglutaminases / Q000276:immunology
D016207:Cytokines; D007070:Immunoglobulin A; D011503:Transglutaminases