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Elevated serum interleukin‐2 after gluten correlates with symptoms and is a potential diagnostic biomarker for coeliac disease
Author(s) -
TyeDin Jason A.,
Daveson A. James M.,
Ee Hooi C.,
Goel Gautam,
MacDougall James,
Acaster Sarah,
Goldstein Kaela E.,
Dzuris John L.,
Neff Kristin M.,
Truitt Kenneth E.,
Anderson Robert P.
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15477
Subject(s) - coeliac disease , medicine , gastroenterology , gluten , nausea , gluten free , vomiting , immunopathology , disease , interleukin 6 , immunology , cytokine , pathology
Summary Background Coeliac disease patients on a gluten‐free diet experience reactions to gluten, but these are not well characterised or understood. Systemic cytokine release was recently linked to reactivation of gluten immunity in coeliac disease. Aim To define the nature and time‐course of symptoms and interleukin‐2 changes specific for coeliac disease patients. Methods 25 coeliac disease patients on a gluten‐free diet and 25 healthy volunteers consumed a standardised 6 gram gluten challenge. Coeliac Disease Patient‐Reported Outcome survey and global digestive symptom assessment were completed hourly up to 6 hours after gluten. Adverse events over 48 hours were recorded. Serum interleukin‐2 was measured at baseline, and 2, 4 and 6 hours. Results Serum interleukin‐2 was always undetectable in healthy controls, whereas it was undetectable at baseline and elevated >0.5 pg/ml at 4 hours in 92% of coeliac disease patients. All patient‐reported outcome severity scores increased significantly after gluten in coeliac disease patients ( P < .001 Wilcoxon signed rank test), but not in controls. Symptoms began after 1 hour, and peaked in the third. Nausea and vomiting characterised severe reactions, but mild reactions were limited to headache and tiredness. Peak interleukin‐2 correlated with symptom severity, particularly for nausea and vomiting. Conclusions Serum interleukin‐2 elevations correlate with timing and severity of symptoms after gluten in coeliac disease. Standardised bolus gluten food challenge and interleukin‐2 assessment could provide a valuable clinical test to monitor and diagnose coeliac disease in patients established on a gluten‐free diet.