International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2014, 2(2), 54-57
DOI: 10.12691/ijcd-2-2-6
Open AccessArticle

Plasma Inflammatory Cytokines as Predictor Markers for Severity of Histological Variations of Intestine among Celiac Patients

Abangah Ghobad1, Asadollahi Ruhangiz2, Rahmani Asghar3, Asadollahi Khairollah4, 5, and Teimouri hadi3

1Department of Gastroenterology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran

2Department of Patology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran

3Student researches committee, Ilam University of Medical Sciences, Ilam, Iran

4Department of Epidemiology. Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran

5The researches centre of Psychosocial injuries, Ilam University of Medical Sciences, Ilam, Iran

Pub. Date: May 11, 2014

Cite this paper:
Abangah Ghobad, Asadollahi Ruhangiz, Rahmani Asghar, Asadollahi Khairollah and Teimouri hadi. Plasma Inflammatory Cytokines as Predictor Markers for Severity of Histological Variations of Intestine among Celiac Patients. International Journal of Celiac Disease. 2014; 2(2):54-57. doi: 10.12691/ijcd-2-2-6

Abstract

Background: Celiac is a chronic hereditary intestinal disorder caused by autoimmune stimulation and injury of intestinal mucosa and different studies have reported an increase of inflammatory cytokines production in these patients. This study aimed to investigate the serum level of inflammatory cytokines and their correlations with the severity of histological variations among celiac patients. Material and methods: By a cross sectional study all celiac patients attending to gastrointestinal clinics in Ilam city during Oct. 2011- MAR. 2013 were investigated. Demographic data was collected using a validate questionnaire and patient's interview and each patient was taken a blood sample for laboratory investigation of tTG-IgA antibody via Elisa test and the serum level of hs-CRP, IL-6 and TNF-a was measured. All patients underwent endoscopic evaluation and biopsy samples were evaluated according to Marsh classification and correlation between severity of histological variations and serum levels of inflammatory cytokines was measured. Results: Totally 274 patients including 90 male and 184 female with a mean age of 28.8±14.4 years were evaluated. The mean serum levels of hs-CRP, IL-6 and TNF-a were 7.8±3.1 mg/l, 2.6±0.9 pg/ml and 6.9±4.6 pg/ml respectively (p=0.599, p=0.629 and p= 0.651). Hs-CRP showed a significant relationship with the severity of mucosal damage upon class I of Marsh classification (p=0.01); however, IL-6 showed a significant level among patients with Marsh I, II and IIIC (p=0.000, p=0.02 and p=0.000) but not in those with Marsh class IIIA and IIIB. Conclusion: There was a positive relationship between mean serum levels of IL-6 and TNF-a with increasing the Marsh classification from class I to class IIIC and the highest rate of IL-6 and TNF-a was shown in Marsh IIIC but the serum level of hs-CRP was not increased with Marsh class increasing. It was concluded that as the Marsh classification increased from class I to class IIIC, and/or the severity of pathologic variations was increased, the mean serum levels of inflammatory markers were increased too.

Keywords:
Celiac hs-CRP IL-6 TNF-a Marsh classification

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References:

[1]  Hill, I.D., et al., Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr, 2005. 40 (1): p. 1-19.
 
[2]  Smits, B.J., History of coeliac disease. BMJ, 1989. 298 (6670): p. 387.
 
[3]  Holtmeier, W. and W.F. Caspary, Celiac disease. Orphanet J Rare Dis, 2006. 1: p. 3.
 
[4]  Fasano, A., et al., Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med, 2003. 163 (3): p. 286-92.
 
[5]  Pittschieler, K. and B. Ladinser, Coeliac disease: screened by a new strategy. Acta Paediatr Suppl, 1996. 412: p. 42-5.
 
[6]  Ascher, H. and B. Kristiansson, Childhood coeliac disease in Sweden. Lancet, 1994. 344 (8918): p. 340-1.
 
[7]  Johnston, S.D., et al., Preliminary results from follow-up of a large-scale population survey of antibodies to gliadin, reticulin and endomysium. Acta Paediatr Suppl, 1996. 412: p. 61-4.
 
[8]  Grodzinsky, E., Screening for coeliac disease in apparently healthy blood donors. Acta Paediatr Suppl, 1996. 412: p. 36-8.
 
[9]  Crone, J., et al., Prevalence of celiac disease and follow-up of EMA in children and adolescents with type 1 diabetes mellitus. J Pediatr Gastroenterol Nutr, 2003. 37 (1): p. 67-71.
 
[10]  Hummel, M., et al., Development of celiac disease-associated antibodies in offspring of parents with type I diabetes. Diabetologia, 2000. 43 (8): p. 1005-11.
 
[11]  Meini, A., et al., Prevalence and diagnosis of celiac disease in IgA-deficient children. Ann Allergy Asthma Immunol, 1996. 77 (4): p. 333-6.
 
[12]  Bonamico, M., et al., Prevalence and clinical picture of celiac disease in Turner syndrome. J Clin Endocrinol Metab, 2002. 87 (12): p. 5495-8.
 
[13]  O'Keeffe, J., et al., Flow cytometric measurement of intracellular migration inhibition factor and tumour necrosis factor alpha in the mucosa of patients with coeliac disease. Clin Exp Immunol, 2001. 125 (3): p. 376-82.
 
[14]  Marsh, M.N., Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'). Gastroenterology, 1992. 102 (1): p. 330-54.
 
[15]  Dieterich, W., et al., Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med, 1997. 3 (7): p. 797-801.
 
[16]  MacDonald, T.T. and J. Spencer, The role of activated T cells in transformed intestinal mucosa. Digestion, 1990. 46 Suppl 2: p. 290-6.
 
[17]  Robert, M.E., Gluten sensitive enteropathy and other causes of small intestinal lymphocytosis. Semin Diagn Pathol, 2005. 22 (4): p. 284-94.
 
[18]  Lio, D., et al., Gluten stimulation induces an in vitro expansion of peripheral blood T gamma delta cells from HLA-DQ2-positive subjects of families of patients with celiac disease. Exp Clin Immunogenet, 1998. 15 (1): p. 46-55.
 
[19]  Westerholm-Ormio, M., et al., Inflammatory cytokines in small intestinal mucosa of patients with potential coeliac disease. Clin Exp Immunol, 2002. 12 8 (1): p. 94-101.
 
[20]  Lahat, N., et al., Cytokine profile in coeliac disease. Scand J Immunol, 1999. 49 (4): p. 441-6.
 
[21]  Cataldo, F., et al., Plasma cytokine profiles in patients with celiac disease and selective IgA deficiency. Pediatr Allergy Immunol, 2003. 14 (4): p. 320-4.