Celiac.com 11/11/2009 - Although doctors view celiac disease mainly as a gastrointestinal disease, it is now known to have widespread systemic manifestations.

A team of researchers recently set out to define the nature and role of systemic cytokine levels in the pathophysiology of celiac disease.  The research team was made up of John Sanil Manavalan, Lincoln Hernandez, Jayesh Girish Shah, John Konikkara, Afzal Jamal Naiyer, Anne Roland Lee, Edward Ciaccio, Maria Theresa Minaya, Peter H.R. Green, and Govind Bhagat of the Departments of Medicine and Pathology at Columbia University's College of Physicians and Surgeons.

The team conducted multiplex cytokine assays on four different groups of adult patients: patients with active celiac disease; patients on a gluten-free diet with positive TTG IgA antibodies, patients on a gluten-free diet with negative antibodies; and those with refractory celiac disease.

They then compared the results against the values in healthy adult controls.

Patients with active celiac disease and those on gluten-free diet with positive antibodies showed substantially higher levels of pro-inflammatory cytokines, such as interferon-, interleukin (IL)–1, tumor necrosis factor–, IL-6 and IL-8, and also Th-2 cytokines such as IL-4 and IL-10, compared with normal controls and patients on a gluten-free diet without antibodies.

One interesting finding was that patients following a gluten-free diet for under 1 year showed substantially higher levels of both pro-inflammatory cytokines and Th2 cytokines compared with the patients on gluten-free diet for more than 1 year.

Moreover, the team noted a statistically significant association between levels of TTG IgA titers and serum levels of Th-2 cytokines IL-4 (p 0.001), IL-10 (p  0.001) and inflammatory cytokines such as IL-1 (p  0.001), IL-1 (p 0.005), and IL-8 (p  0.05).

Journal of Human Immunology, 2009.
j.humimm.2009.09.351

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