Gene expression profile of peripheral blood monocytes: a step towards the molecular diagnosis of celiac disease?
OBJECTIVE
Celiac disease (CD) is a multifactorial autoimmune disease induced by ingestion of gluten in genetically predisposed individuals. Despite technological progress, the diagnosis of CD is still based on duodenal biopsy as it was 50 years ago. In this study we analysed the expression of CD-associated genes in small bowel biopsies of patients and controls in order to explore the multivariate pathway of the expression profile of CD patients. Then, using multivariant discriminant analysis, we evaluated whether the expression profiles of these genes in peripheral blood monocytes (PBMs) differed between patients and controls.


METHODS
Thirty-seven patients with active and 11 with treated CD, 40 healthy controls and 9 disease controls (Crohn's disease patients) were enrolled.


RESULTS
Several genes were differentially expressed in CD patients versus controls, but the analysis of each single gene did not provided a comprehensive picture. A multivariate discriminant analysis showed that the expression of 5 genes in intestinal mucosa accounted for 93% of the difference between CD patients and controls. We then applied the same approach to PBMs, on a training set of 20 samples. The discriminant equation obtained was validated on a testing cohort of 10 additional cases and controls, and we obtained a correct classification of all CD cases and of 91% of the control samples. We applied this equation to treated CD patients and to disease controls and obtained a discrimination of 100%.


CONCLUSIONS
The combined expression of 4 genes allows one to discriminate between CD patients and controls, and between CD patients on a gluten-free diet and disease controls. Our results contribute to the understanding of the complex interactions among CD-associated genes, and they may represent a starting point for the development of a molecular diagnosis of celiac disease.
Department of Translational Medical Science, University of Naples Federico II, Naples, Italy ; European Laboratory for Food-Induced disease (ELFID), University of Naples Federico II, Naples, Italy ; Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy.
Martina
M
Galatola
Valentina
V
Izzo
Donatella
D
Cielo
Marinita
M
Morelli
Giuseppina
G
Gambino
Delia
D
Zanzi
Caterina
C
Strisciuglio
Maria Pia
MP
Sperandeo
Luigi
L
Greco
Renata
R
Auricchio
D000293:Adolescent; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000378:metabolism / Q000473:pathology; D005260:Female; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D059467:Transcriptome
D012333:RNA, Messenger