Evaluation of Gut Permeability and Immune Responses in Celiac Disease: Correlating Intestinal Barrier Function with Systemic Immune Activation Markers
DOI:
https://doi.org/10.51699/ijhsms.v4i1.406Keywords:
celiac disease, intestinal permeability, lactulose-to-mannitol (L/M) ratio, serum levels of anti-tTG IgA, anti-DGP IgG, IL-2, TNF-α, IFN-γAbstract
Background: Celiac disease is an autoimmune disorder characterized by intestinal inflammation and increased gut permeability. Here, we aimed to evaluate intestinal permeability in celiac disease patients and its correlation with systemic immune activation markers, including serum antibodies and cytokines. Methods: A total of 120 patients diagnosed with celiac disease were compared with 85 healthy non-celiac group (control). Demographic data, body mass index (BMI), medication use, family history and symptomatology were recorded. Intestinal permeability was assessed using the lactulose-to-mannitol (L/M) ratio, and serum levels of anti-tTG IgA, anti-DGP IgG, IL-2, TNF-α, and IFN-γ were measured. Spearman’s correlation analysis was performed to explore relationships between the L/M ratio and other parameters. Results: The mean age of celiac disease patients was 46.55 ± 8.57 years, with no significant age difference compared to controls (p = 0.219). The celiac disease group exhibited a significantly higher BMI (29.96 ± 5.09) compared to controls (25.47 ± 4.51, p < 0.0001). Medication use was prevalent in 86.7% of celiac disease patients, contrasting with none in the control group (p < 0.0001). A significant family history of celiac disease was noted in 74.7% of patients (p < 0.0001). Intestinal permeability testing revealed a mean lactulose percentage of 0.21 ± 0.04% in celiac disease patients versus 0.08 ± 0.02% in controls (p < 0.0001), with a mean mannitol percentage of 13.98 ± 2.48% in celiac disease patients compared to 24.59 ± 3.39% in controls (p < 0.0001). Strong positive correlations were observed between the L/M ratio and anti-tTG IgA (rs = 0.724), anti-DGP IgG (rs = 0.765), IL-2 (rs = 0.720), TNF-α (rs = 0.591), and IFN-γ (rs = 0.716), all with p-values < 0.0001. Conclusions: Our findings demonstrated that increase intestinal permeability in celiac disease is significantly correlated with elevated levels of specific autoantibodies and pro-inflammatory cytokines. These findings highlight the importance of assessing gut permeability as a potential marker of disease activity and immune response in celiac disease patients.
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