Department of Clinical Microbiology, Immunology, Umeå University, Umeå, Sweden.
Department of Clinical and Experimental Medicine, Medical Microbiology, Linköping University, Linköping, Sweden.
Clin Transl Gastroenterol. 2014 Jun 26;5(6):e58. doi: 10.1038/ctg.2014.9.
Life-long, strict gluten-free diet (GFD) is the only treatment for celiac disease (CD). Because there is still uncertainty regarding the safety of oats for CD patients, the aim was to investigate whether dietary oats influence the immune status of their intestinal mucosa.
Paired small intestinal biopsies, before and after >11 months on a GFD, were collected from children with CD who were enrolled in a randomized, double-blind intervention trial to either of two diets: standard GFD (GFD-std; n=13) and noncontaminated oat-containing GFD (GFD-oats; n=15). Expression levels of mRNAs for 22 different immune effector molecules and tight junction proteins were determined by quantitative reverse transcriptase (RT)-PCR.
The number of mRNAs that remained elevated was higher in the GFD-oats group (P=0.05). In particular, mRNAs for the regulatory T cell (Treg) signature molecules interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1), the cytotoxicity-activating natural killer (NK) receptors KLRC2/NKG2C and KLRC3/NKG2E, and the tight junction protein claudin-4 remained elevated. Between the two groups, most significant differences were seen for claudin-4 (P=0.003) and KLRC3/NKG2E (P=0.04).
A substantial fraction of pediatric CD patients seem to not tolerate oats. In these patients, dietary oats influence the immune status of the intestinal mucosa with an mRNA profile suggesting presence of activated cytotoxic lymphocytes and Tregs and a stressed epithelium with affected tight junctions. Assessment of changes in levels of mRNA for claudin-4 and KLC3/NKG2E from onset to after a year on oats containing GFD shows promise to identify these CD patients.
终生严格的无麸质饮食（GFD）是治疗乳糜泻（CD）的唯一方法。由于对于 CD 患者食用燕麦的安全性仍存在不确定性，因此本研究旨在探讨饮食中添加燕麦是否会影响其肠黏膜的免疫状态。
纳入参加一项随机、双盲干预试验的 CD 患儿，收集其在接受 GFD 治疗>11 个月前后的配对小肠活检样本。这些患儿被分为两组，分别接受标准 GFD（GFD-std；n=13）或无污染物燕麦的 GFD（GFD-oats；n=15）。通过定量逆转录（RT）-PCR 检测 22 种不同免疫效应分子和紧密连接蛋白的 mRNA 表达水平。
在 GFD-oats 组，mRNA 升高的数量更多（P=0.05）。特别是调节性 T 细胞（Treg）特征分子白细胞介素 10（IL-10）和转化生长因子-β1（TGF-β1）、细胞毒性激活的自然杀伤（NK）受体 KLRC2/NKG2C 和 KLRC3/NKG2E，以及紧密连接蛋白 Claudin-4 的 mRNA 仍呈高表达状态。在两组之间，Claudin-4（P=0.003）和 KLRC3/NKG2E（P=0.04）的差异最显著。
相当一部分儿科 CD 患者似乎不能耐受燕麦。在这些患者中，饮食中的燕麦会影响肠黏膜的免疫状态，其 mRNA 谱提示存在激活的细胞毒性淋巴细胞和 Treg，以及上皮细胞紧张和紧密连接受损。从发病到接受含燕麦的 GFD 治疗 1 年后，评估 Claudin-4 和 KLC3/NKG2E 的 mRNA 水平变化，有望识别出这些 CD 患者。
