Original Article

Digestive Diseases and Sciences

, Volume 56, Issue 3, pp 792-798

Immune Phenotype of Children with Newly Diagnosed and Gluten-Free Diet-Treated Celiac Disease

  • Áron CsehAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics Email author 
  • , Barna VásárhelyiAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of PediatricsDepartment of Laboratory Medicine, Semmelweis University
  • , Balázs SzalayAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics
  • , Kriszta MolnárAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics
  • , Dorottya Nagy-SzakálAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics
  • , András TreszlAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics
  • , Ádám VannayAffiliated withResearch Group for Pediatrics and Nephrology, Semmelweis University and Hungarian Academy of Sciences, First Department of Pediatrics
  • , András AratóAffiliated withFirst Department of Pediatrics, Semmelweis University
  • , Tivadar TulassayAffiliated withFirst Department of Pediatrics, Semmelweis University
    • , Gábor VeresAffiliated withFirst Department of Pediatrics, Semmelweis University

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Abstract

Background

Recent data suggest the involvement of both the adaptive and the innate immune system in celiac disease (CD). However, little is known about the immune phenotype of children with CD and its alteration upon dietary intervention.

Aims

We characterized the prevalence of major interacting members of the adaptive and innate immune system in peripheral blood of newly diagnosed children with CD and tested its alteration with the improvement of clinical signs after the introduction of gluten-free diet (GFD).

Methods

Peripheral blood was taken from ten children with biopsy-proven CD at the time of diagnosis and after the resolution of clinical symptoms following GFD. As controls, 15 children with functional abdominal pain were enrolled. The prevalence of the cells of adaptive and innate immunity was measured with labeled antibodies against surface markers and intracellular FoxP3 using a flow cytometer.

Results

Patients with CD were found to have lower T helper, Th1 and natural killer (NK), NKT and invariant NKT cell prevalence and with higher prevalence of activated CD4+ cells, myeloid dendritic cells (DC) and Toll-like receptor (TLR) 2 and TLR-4 positive DCs and monocytes compared to controls. After resolution of symptoms on GFD, the majority of these changes normalized, although the prevalence of NK and NKT cell, DC and TLR-2 expressing DCs and monocytes remained abnormal.

Conclusions

The immune phenotype in childhood CD indicates the implication of both adaptive and innate immune system. The normalization of immune abnormalities occurs on GFD, but the kinetics of this process probably differs among different cell types.

Keywords

Celiac disease Lymphocyte Regulatory T cell Dendritic cell Monocyte Toll-like receptor