علاقة مستويات الانترلوكينات (sIL-2R & IL-18) في مصل الدم مع الاجسام الذاتية المضادة لدى المصابين بمرض السيلياك في محافظة كربلاء

Correlation of Serum Soluble Interleukin-2 Receptor and Interleukin-18 with Auto-antibody Profile In Patients With Celiac Disease In Karbala Province

Abstract

Celiac disease is an autoimmune chronic disease involving mainly the digestive system with variable degree of severity and type of presenting symptoms. It’s triggered by ingesting gluten-containig food, found mainly in wheat, barley, and rye in the genetically predisposed people of all ages. For decades, the pathogenesis of celiac disease has been focused on and tried to connect with other human autoimmune disorders. Several factors are stimulating the onset of the disease including environmental, genetic and local immune disorders.
The aim of this study is to comparatively assess serum soluble interleukin-2receptor (sIL-2R) and interleukin 18 (IL-18) with anti-tissue transglutaminase (anti- tTG) and anti-deamidated gliadin peptide (anti-DGP) antibodies across biodemographic factors in patients with celiac disease.
The tissue transglutaminase(tTG) enzyme and deamidated gliadin peptide (DGP) are involved in the series of the immune processes associated with the celiac disease .The sIL-2R together with IL-18 are predictive markers for inflammatory process of small intestine in adult Iraqi people with celiac disease since both markers are upregulated in the disease. Histological examination for duodenal tissue biopsies which was considered as a cornerstone in the diagnosis of celiac disease for several decades was used in this study and by applying MARSH grading system in this examination.
Method: cross sectional study was carried out to test 45 patients with celiac disease of adult age group of both genders for serum level of the four markers using an ELISA technique then to be compared with 45 healthy controls comparable for age and gender. Endoscopic obtained biopsies from patient’s duodenal tissues were examined histologically (by applying hematoxylin and eosin protocol) with a subsequent MARSH grading.
Results: High serum anti-tTG, DGP , IL-18 and sIL-2R concentrations were noticed in the majority of the patients with celiac disease, which was probably attributed to consumption of gluten in the diet of most of the candidates. This study demonstrates a significant statistical difference in serum levels of the above four markers among those patients in comparison to controls group (p< 0.05).There were significant correlations of anti-tTG,IL-18,and sIL-2R markers level with the different histological grades(p< 0.05).
Conclusion: The inflammatory process associated with CD can be monitored by detecting the serum level of pro-inflammatory cytokines of the patients and so the physicians can predict the clinical outcome. This review also calls for investigating persons who have refractory anemia or unusual extraintestinal features. The usage of the serological inflammatory markers may reduce the need for application of the oesophageogastroduodenoscopy (OGD).