Gluten-free diet may not influence immune-mediated diseases in celiac disease

Last Updated: 2016-04-29

By Reuters Staff

NEW YORK (Reuters Health) - A gluten-free diet does not appear to alter the incidence or the nature of immune-mediated diseases in patients with celiac disease, researchers report.

Celiac disease is mediated by a T helper cell type (Th) 1 immune response to gluten, and both Th1/Th17- and Th2-mediated diseases may coexist in cases of celiac disease.

Dr. Nicola Imperatore from School of Medicine Federico II of Naples, Italy, and colleagues investigated the prevalence of immune-mediated diseases at the time of and after the diagnosis of celiac disease in 1,255 patients and sought to determine the influence of gluten-free diet on those diseases.

One in five of these patients suffered from at least one immunological/allergic immune-mediated disease before their diagnosis of celiac disease, of which 58% were Th1/Th17 mediated and 42% were Th2 mediated, the researchers report in Digestive and Liver Disease, online April 9.

In the five years following the diagnosis of celiac disease, another 54% of patients developed immune-mediated disease regardless of whether they were following a strict gluten-free diet. The distribution of Th1/Th17- and Th2-mediated disease was similar before and after the diagnosis of celiac disease.

There was no correlation between the occurrence of immune-mediated disease and age at the time of celiac disease diagnosis, anti-tissue transglutaminase serum levels at the time of diagnosis and at follow-up, Marsh grade, or clinical symptoms.

"Our results suggest that we should re-examine the widely shared view that gluten-free diet is a magic bullet for the treatment of all pathological conditions associated with celiac disease," the researchers conclude.

Dr. Imperatore did not respond to a request for comments.

SOURCE: http://bit.ly/1SCRMXo

Dig Liver Dis 2016.