Nicola Imperatore1, Antonio Rispo2, Pietro Capone2, Sara Donetto3, Giovanni Domenico De Palma4, Nicolò Gerbino2, Matilde Rea2, Nicola Caporaso2, Raffaella Tortora2. 1. Gastroenterology, Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy. Electronic address: nicola.imperatore@alice.it. 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.
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.
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.
Authors: Tom van Gils; Petula Nijeboer; Jan Hein Tm van Waesberghe; Veerle Mh Coupé; Kiki Janssen; Jessy A Zegers; Shaikh A Nurmohamed; Georg Kraal; Sabine Ci Jiskoot; Gerd Bouma; Chris Jj Mulder Journal: United European Gastroenterol J Date: 2016-08-17 Impact factor: 4.623
Authors: Patricia Dominguez Castro; Grace Harkin; Mary Hussey; Brian Christopher; Clifford Kiat; Jun Liong Chin; Valerie Trimble; Deirdre McNamara; Padraic MacMathuna; Brian Egan; Barbara Ryan; David Kevans; Mohamed Abuzakouk; Richard Farrell; Con Feighery; Valerie Byrnes; Nasir Mahmud; Ross McManus Journal: United European Gastroenterol J Date: 2020-01-07 Impact factor: 4.623