Original contribution
Pre- and post-treatment serum levels of cytokines IL-1β, IL-6, and IL-1 receptor antagonist in celiac disease. Are they related to the associated osteopenia?

https://doi.org/10.1016/S0002-9270(97)00115-9Get rights and content

Objective

Decreased bone mineral density is a common finding in untreated celiac disease patients. However, the precise pathophysiology of osteopenia remains incompletely understood. Pathological features of gluten sensitivity are associated with local release of proinflammatory and antiinflammatory cytokines. We investigated the serum levels of IL-1β, IL-6, and IL-1 receptor antagonist in celiac patients and correlated them with bone density measurements. Methods: We assessed serum samples of 16 female patients at the time of diagnosis (on an unrestricted diet) and after a mean time of 37 months on a gluten-free diet. At the same time, bone mineral density in the lumbar spine and total skeleton was determined by DEXA.

Results

Untreated patients had high serum levels of IL-1β and IL-6 and normal IL-1-RA. Treatment produced a decrease in median IL-1β levels (p = NS) and a significant diminution of IL-6 (p < 0.05). On the contrary, IL-1-RA increased significantly after treatment (p < 0.05). Baseline lumbar spine Z-score and IL-6 levels exhibited a significant inverse correlation (r = −0.61;p < 0.01). Patients with more severe baseline osteopenia (< −2 Z-scores) had a significantly lower IL-1-RA than those with less bone compromise (> −2 Z-scores).

Conclusions

Our data demonstrate that the inflammatory process observed in active celiac disease is associated with high serum levels of IL-1β and IL-6 and normal levels of IL-1-RA. Treatment significantly reduces both proinflammatory cytokines and significantly increases the antiinflammatory one. We also suggest that these cytokines might have a role in the osteopenia associated with celiac disease.

References (28)

  • GonzalezD et al.

    Body composition and bone mineral density in untreated and treated patients with celiac disease

    Bone

    (1995)
  • CaraceniM et al.

    Bone and mineral metabolism in adult celiac disease

    Am J Gastroemerol

    (1988)
  • MolteniN et al.

    Bone mineral density in adult celiac patients and the effect of gluten-free diet from childhood

    Am J Gastroenterol

    (1990)
  • MazureR et al.

    Bone mineral affectation in asymptomatic adult patients with celiac disease

    Am J Gastroenterol

    (1994)
  • McfarlaneX et al.

    Osteoporosis in treated adults coeliac disease

    Gut

    (1995)
  • BodeS et al.

    Body composition and calcium metabolism in adult treated coeliac disease

    Gut

    (1991)
  • ValdimarssonT et al.

    Bone mineral density in coeliac disease

    Scand J Gastroenterol

    (1994)
  • MautalenC et al.

    Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients

    Am J Gastroenterol

    (1997)
  • BaiJC et al.

    Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease

    Alim Pharmacol Ther

    (1997)
  • MarshMN

    Gluten histocompatibility complex, and the small intestine: A molecular and immunobiologic approach to the spectrum of gluten sensitivity (“celiac sprue”)

    Gastroenterology

    (1992)
  • VazquezH et al.

    Serological markers identify latent coeliac disease among first-degree relatives

    Eur J Gastroenterol Hepatol

    (1996)
  • KontakouM et al.

    Expression of tumor necrosis factor-α interleukin-6, and interleukin-2 mRNA in the jejunum of patients with coeliac disease

    Scand J Gastroenterol

    (1996)
  • PrzemiosloRT et al.

    Raised pro-inflammatory cytokines interleukin-6 and tumor necrosis factor α in coeliac disease mucosa detected by immunohistochemistry

    Gut

    (1994)
  • RaiszFH

    Local and systemic factors in the pathogenesis of osteoporosis

    N Engl J Med

    (1988)
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