Serum Cytokines Profile in Treated Celiac Disease Compared with Non-celiac Gluten Sensitivity and Control: a Marker for Differentiation
Fatemeh Heydari1,2, Mohammad Rostami-Nejad2, Ali Moheb-Alian3, Mostafa Haji Mollahoseini1, Kamran Rostami4, Mohamad Amin Pourhoseingholi2, Elham Aghamohammadi2, Mohammad Reza Zali1
1) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2) Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3) Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4) Department of Gastroenterology, MidCentral District Health Board, Palmerston North Hospital, Palmerston North, New Zealand
Background & Aims: There is increasing evidence regarding elevated serum levels of inflammatory cytokines in patients with celiac disease (CD), but little is known about their levels in patients with non-celiac gluten sensitivity (NCGS). The aim of this study was to evaluate the serum levels of inflammatory cytokines in Iranian patients with CD and NCGS and to compare them with those of healthy individuals.
Methods: A total of 110 treated CD, 15 with NCGS, and 46 healthy subjects were enrolled during 2016. Serum levels of IL-1, IL-6, IL-8, IL-15 and IFN-γ were measured using ELISA, and compared between groups. The correlation of the severity of mucosal damage and clinical symptoms with serum levels of cytokines was also assessed.
Results: The mean serum levels of IFN-γ (p = 0.04) and IL-6 (p = 0.007) were significantly different between the patients in the CD and control groups, and IL-8 was significantly higher in the CD group compared with patients in the NCGS group (p = 0.04). Statistically significant correlations were observed between the serum levels of IFN-γ and abortion (p = 0.01), IL-1 and weight loss (p = 0.043) and infertility (p = 0.0001) in CD patients, and between IFN-γ and abortion (p = 0.01) and infertility (p = 0.01) in the NCGS patients. Moreover, no significant relationship was observed between the severity of mucosal damage and the serum level of the studied cytokines.
Conclusions: Inflammatory cytokines are implicated in the pathogenesis of CD, and their serum levels might help to identify a diagnostic marker to differentiate CD from NCGS. However, further studies with a larger sample size are recommended.
Key words: Celiac Disease − Inflammatory Cytokines − Non-celiac Gluten Sensitivity − Clinical Manifestations.
Abbreviations: CD: Celiac disease; EMA: Endomysial antibodies; IFN-γ: Interferon gamma; GFD: Gluten free diet; GI: gastrointestinal; NCGS: Non-celiac gluten sensitivity; RT-PCR: Reverse transcription polymerase chain reaction; tTG: Tissue-transglutaminase.