SERUM CYTOKINE PATTERNS IN CELIAC DISEASE

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SERUM CYTOKINE PATTERNS IN CELIAC DISEASE

• Shabab Naqvi Ibrahim Ibrahim
• Mentor Dr. Sanil Manavalan
• Columbia University, College of Physicians and
  Surgeons

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• Celiac disease
• a digestive disease that damages the small
  intestine and interferes with absorption of
  nutrients from food
• it is a genetic disorder
• some of the symptoms of celiac disease are
  diarrhea, weight loss, malnutrition, etc
• when people with celiac disease eat foods
  containing gluten, their immune system responds
  by damaging the small intestine
• Diagnosis is by intestinal biopsy histological
  grading and presence of serum auto- antibodies.

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Key Terms

• Cytokines soluble peptides or glycoproteins
  that regulate immune, inflammatory responses
  and other biologic processes.
• Interleukin (IL) cytokines that only affect
  leukocytes.
• Lymphocyte A type of leukocyte (white blood
  cell) of the immune system.
• T-Regulatory Cell slows down and stops immune
  response
• T-Helper Cell (Th cell) has antigen-receptors,
  releases cytokines
• Natural Killer Cell kills macrophage and bad
  stuff
• Cytotoxic T-Cell kills cells that produce
  foreign antigens such as cells infected by
  viruses
• B-Cell creates antibodies.
• Antigen invading microbe
• Antibody protein that fights bacteria and
  viruses.

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The Gut Lumen
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(No Transcript)
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GUT LUMEN
GUT LUMEN
Gliadin
Enterocytes
LAMINA PROPRIA AND INTRA EPITHILIAL SPACE
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AIMS
Define the serum cytokine profile in patients
with Celiac Disease
A) Active Disease B) Gluten Free
Diet (GFD) C) Refractory disease (RD)
D) Normals/Controls
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METHODOLOGY
Serum Samples from A) Active Disease (25) B)
Gluten Free Diet (GFD) (43) C) Refractory
disease (6) D) Controls
(16) Measured using a Cytokine Bio-chip Array
(RANDOX laboratories Ltd) Mann-Whitney Rank
test and Student T-test to determine differences
in the means of individual groups of patients
Cytokines Measured
Th-1 Derived IL-2 IFN-?
Th-2 Derived IL-4 IL-6 IL-10
APC Derived IL-8, IL-1a, IL-1b, TNF-a
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RESULTS
P 0.01
P 0.006
P 0.06
IL-4 (pg/ml)
P lt0.005
P 0.04
P 0.004
IFN-g (pg/ml)
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ACTIVE CD VS. NORMALS
Active CD n 25 Controls n 16
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GFD vs. Normals
APC Derived
Th-2 Derived
Th-1 Derived
GFD n 43 Controls n16
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SUMMARY

• Patients with Celiac Disease (AD, GFD or RD) have
  significantly higher levels of pro-inflammatory,
  TH1( (IFN-?) and TH2 (IL-4, IL-6, IL-8) cytokines
  when compared to normal controls.
• Patients on therapy (gluten-free-diet) had fewer
  pro-inflammatory cytokines with elevated levels
  than Active disease patients

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CONCLUSIONS

• A better understanding of cytokine abnormalities
  may provide insight
• into
• -Systemic symptoms
• -Disease pathogenesis
• -Better monitoring of disease
  activity
• -New therapeutic and prognostic
  modalities

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THANK YOU

• To Dr. Sanil Manavalan
• Dr. Jamal Naiyer
• Dr. Sat Bhattacharya
• Harlem Children Society