Novel Method Identifies Patients with Celiac Disease

Celiac disease is a T cell-mediated autoimmune disease triggered by the ingestion of gluten from wheat, rye and barley in genetically susceptible individuals. A gluten-free diet is the only current management for this disease.

When a person with celiac disease consumes gluten, the individual's immune system responds by triggering T cells to fight the offending proteins, damaging the small intestine and inhibiting the absorption of important nutrients into the body. Undiagnosed, celiac disease is a major contributor to poor educational performance and failure to thrive in children.

Scientists at the Walter and Eliza Hall Institute carried out a randomized, double-blind, placebo-controlled food challenge study that enrolled volunteers with HLA-DQ2.5+ celiac disease who were compliant with a gluten-free diet. In the study, 21 volunteers received either vital wheat gluten flour or a matched gluten-free flour drink over the course of 10 minutes. Serum chemokines and cytokines were measured 30 minutes prior to food challenge, then at four, six, and 24 hours after the challenge. Vital signs and patient-reported outcomes (CeD PRO) were recorded hourly.

The team demonstrated that, at four hours following food challenge, serum levels of the cytokine interleukin-8 (IL-8) were significantly higher after exposure to gluten than placebo with a median fold change from baseline: gluten: 2.4 versus placebo: 1.1. Serum levels of IL-2 were also significantly increased at four hours, confirming T-cell activation in response to gluten exposure with a median fold change from baseline: gluten: 19.5 versus placebo: 0.7.

Robert (Bob) Anderson, BMedSc, MB, ChB, PhD, FRACP, Chief Scientific Officer of ImmusanT, a clinical-stage company developing Nexvax2, a therapeutic vaccine intended to protect against the effects of gluten exposure, said, “In this study, we have identified a distinct cytokine signature present in the serum of subjects with celiac disease four hours after the ingestion of gluten, suggesting that the measurement of serum cytokines following a single gluten challenge may allow for the identification of patients on a gluten-free diet with celiac disease.” The study was presented at the Digestive Disease Week, held May 6-9, in Chicago, IL, USA.