Cytokine release after gluten ingestion differentiates coeliac disease from self-reported gluten sensitivity
- Author(s)
- Tye-Din, Jason A; Skodje, Gry I; Sarna, Vikas K; Dzuris, John L; Russell, Amy K; Goel, Gautam; Wang, Suyue; Goldstein, Kaela E; Williams, Leslie J; Sollid, Ludvig M; Lundin, Knut EA; Anderson, Robert P;
- Journal Title
- United European Gastroenterology Journal
- Publication Type
- Journal Article in press
- Abstract
- BackgroundDiagnosing coeliac disease (CD) in patients on a gluten-free diet (GFD) is difficult. Ingesting gluten elevates circulating interleukin (IL)-2, IL-8 and IL-10 in CD patients on a GFD.ObjectiveWe tested whether cytokine release after gluten ingestion differentiates patients with CD from those with self-reported gluten sensitivity (SR-GS).MethodsAustralian patients with CD (n?=?26) and SR-GS (n?=?18) on a GFD consumed bread (estimated gluten 6?g). Serum at baseline and at 3 and 4?h was tested for IL-2, IL-8 and IL-10. Separately, Norwegian SR-GS patients (n?=?49) had plasma cytokine assessment at baseline and at 2, 4 and 6?h after food bars containing gluten (5.7?g), fructan or placebo in a previous double-blind crossover study.ResultsGluten significantly elevated serum IL-2, IL-8 and IL-10 at 3 and 4?h in patients with CD but not SR-GS. The highest median fold-change from baseline at 4?h was for IL-2 (8.06, IQR: 1.52?24.0; P?<?0.0001, Wilcoxon test). The two SR-GS cohorts included only one (1.5%) confirmed IL-2 responder, and cytokine responses to fructan and placebo were no different to gluten. Overall, cytokine release after gluten was present in 22 (85%) CD participants, but 2 of the 4 non-responders remained clinically well after 1 y on an unrestricted diet. Hence, cytokine release occurred in 22 (92%) of 24 ?verified? CD participants.ConclusionsGluten challenge with high-sensitivity cytokine assessment differentiates CD from SR-GS in patients on a GFD and identifies patients likely to tolerate gluten reintroduction. Systemic cytokine release indicating early immune activation by gluten in CD individuals cannot be detected in SR-GS individuals.
- Publisher
- SAGE Publications
- Research Division(s)
- Immunology
- Publisher's Version
- https://doi.org/10.1177/2050640619874173
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- Refer to copyright notice on published article.
Creation Date: 2019-09-20 10:16:34
Last Modified: 2019-09-24 03:53:28