Immune phenotype of children with newly diagnosed and gluten-free diet-treated celiac disease.
BACKGROUND
Recent data suggest the involvement of both the adaptive and the innate immune system in celiac disease (CD). However, little is known about the immune phenotype of children with CD and its alteration upon dietary intervention.


OBJECTIVE
We characterized the prevalence of major interacting members of the adaptive and innate immune system in peripheral blood of newly diagnosed children with CD and tested its alteration with the improvement of clinical signs after the introduction of gluten-free diet (GFD).


METHODS
Peripheral blood was taken from ten children with biopsy-proven CD at the time of diagnosis and after the resolution of clinical symptoms following GFD. As controls, 15 children with functional abdominal pain were enrolled. The prevalence of the cells of adaptive and innate immunity was measured with labeled antibodies against surface markers and intracellular FoxP3 using a flow cytometer.


RESULTS
Patients with CD were found to have lower T helper, Th1 and natural killer (NK), NKT and invariant NKT cell prevalence and with higher prevalence of activated CD4(+) cells, myeloid dendritic cells (DC) and Toll-like receptor (TLR) 2 and TLR-4 positive DCs and monocytes compared to controls. After resolution of symptoms on GFD, the majority of these changes normalized, although the prevalence of NK and NKT cell, DC and TLR-2 expressing DCs and monocytes remained abnormal.


CONCLUSIONS
The immune phenotype in childhood CD indicates the implication of both adaptive and innate immune system. The normalization of immune abnormalities occurs on GFD, but the kinetics of this process probably differs among different cell types.
Cseh
Áron
Á
Research Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics, Bókay u. 53, 1083, Budapest, Hungary. cseharon@gmail.com
Vásárhelyi
Barna
B
Szalay
Balázs
B
Molnár
Kriszta
K
Nagy-Szakál
Dorottya
D
Treszl
András
A
Vannay
Ádám
Á
Arató
András
A
Tulassay
Tivadar
T
Veres
Gábor
G
D056704:Adaptive Immunity; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000276:immunology*; D002675:Child, Preschool; D003713:Dendritic Cells / Q000276:immunology; D055050:Diet, Gluten-Free; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D005983:Glutens / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D009000:Monocytes / Q000276:immunology; D055611:Natural Killer T-Cells / Q000276:immunology; D010641:Phenotype; D010865:Pilot Projects; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D051195:Toll-Like Receptor 2 / Q000276:immunology; D051197:Toll-Like Receptor 4 / Q000276:immunology
C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C495342:TLR2 protein, human; C495345:TLR4 protein, human; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D005983:Glutens