Gluten-free diet does not influence the occurrence and the Th1/Th17-Th2 nature of immune-mediated diseases in patients with coeliac disease

Nicola Imperatore; Antonio Rispo; Pietro Capone; Sara Donetto; Giovanni Domenico De Palma; Nicolò Gerbino; Matilde Rea; Nicola Caporaso; Raffaella Tortora

doi:10.1016/j.dld.2016.03.026

Gluten-free diet does not influence the occurrence and the Th1/Th17-Th2 nature of immune-mediated diseases in patients with coeliac disease

Dig Liver Dis. 2016 Jul;48(7):740-4. doi: 10.1016/j.dld.2016.03.026. Epub 2016 Apr 9.

Authors

Nicola Imperatore¹, Antonio Rispo², Pietro Capone², Sara Donetto³, Giovanni Domenico De Palma⁴, Nicolò Gerbino², Matilde Rea², Nicola Caporaso², Raffaella Tortora²

Affiliations

¹ Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy. Electronic address: [email protected].
² Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy.
³ Department of Education and Professional Studies, King's College London, London, UK.
⁴ Surgical Endoscopy, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy.

PMID: 27133207
DOI: 10.1016/j.dld.2016.03.026

Abstract

Introduction: Coeliac disease (CD) is the most common Th1-mediated enteropathy, frequently associated with other immune-mediated disorders (IMD).

Aims: To evaluate: (1) the prevalence of IMD at the time of and after CD diagnosis; (2) a possible change in immune response to gluten free diet (GFD); (3) the potential role of GFD in reducing and/or preventing IMD in CD.

Methods: Prospective study including all consecutive adult CD patients who underwent investigations for Th1-Th17/Th2-IMD at the time of CD diagnosis and after a 5-year follow-up period.

Results: 1255 CD were enrolled. Of these, 257 patients (20.5%) showed IMD at the time of CD diagnosis, with 58.4% presenting a Th1/Th17-IMD. After a 5-year follow-up period, 682 patients (54.3%) showed new IMD despite GFD. Of these, 57.3% presented a Th1/Th17-IMD and 42.7% a Th2-IMD (p=0.8). When compared the prevalence of each type of IMD before and after CD diagnosis, we did not identify any significant "switch" from Th1/Th17- to Th2-IMD or vice versa. The number of patients with Th1/Th17- and/or Th2-IMD increased during the GFD period (20.5% vs 54.3%; p<0.01; OR 1.9).

Conclusions: The prevalence of IMD at the time of CD diagnosis is high and it seems to increase in the follow-up period despite GFD.

Keywords: Autoimmunity; Coeliac disease; Gluten; Immuno-mediated diseases; Th1; Th17; Th2.

MeSH terms

Adolescent
Adult
Autoimmune Diseases / epidemiology*
Celiac Disease / diet therapy*
Celiac Disease / epidemiology*
Celiac Disease / immunology*
Diet, Gluten-Free*
Female
Follow-Up Studies
Humans
Italy
Male
Prospective Studies
T-Lymphocytes, Helper-Inducer / immunology*
Young Adult