ImmusanT, Inc., Cambridge, MA,, USA.
Faculty of Medicine, University of Queensland, 288 Herston Rd, Herston, 4006, QLD, Australia.
Clin Exp Immunol. 2020 Jan;199(1):68-78. doi: 10.1111/cei.13369. Epub 2019 Oct 1.
Cytokines have been extensively studied in coeliac disease, but cytokine release related to exposure to gluten and associated symptoms has only recently been described. Prominent, early elevations in serum interleukin (IL)-2 after gluten support a central role for T cell activation in the clinical reactions to gluten in coeliac disease. The aim of this study was to establish a quantitative hierarchy of serum cytokines and their relation to symptoms in patients with coeliac disease during gluten-mediated cytokine release reactions. Sera were analyzed from coeliac disease patients on a gluten free-diet (n = 25) and from a parallel cohort of healthy volunteers (n = 25) who underwent an unmasked gluten challenge. Sera were collected at baseline and 2, 4 and 6 h after consuming 10 g vital wheat gluten flour; 187 cytokines were assessed. Confirmatory analyses were performed by high-sensitivity electrochemiluminescence immunoassay. Cytokine elevations were correlated with symptoms. Cytokine release following gluten challenge in coeliac disease patients included significant elevations of IL-2, chemokine (C-C motif) ligand 20 (CCL20), IL-6, chemokine (C-X-C motif) ligand (CXCL)9, CXCL8, interferon (IFN)-γ, IL-10, IL-22, IL-17A, tumour necrosis factor (TNF)-α, CCL2 and amphiregulin. IL-2 and IL-17A were earliest to rise. Peak levels of cytokines were generally at 4 h. IL-2 increased most (median 57-fold), then CCL20 (median 10-fold). Cytokine changes were strongly correlated with one another, and the most severely symptomatic patients had the highest elevations. Early elevations of IL-2, IL-17A, IL-22 and IFN-γ after gluten in patients with coeliac disease implicates rapidly activated T cells as their probable source. Cytokine release after gluten could aid in monitoring experimental treatments and support diagnosis.
细胞因子在乳糜泻中得到了广泛的研究,但与接触麸质和相关症状相关的细胞因子释放最近才被描述。在乳糜泻中,麸质支持 T 细胞激活在对麸质的临床反应中起核心作用,这一观点得到了血清白细胞介素 (IL)-2 早期升高的支持。本研究的目的是在乳糜泻患者的麸质介导的细胞因子释放反应中,建立一个血清细胞因子的定量层次及其与症状的关系。在无麸质饮食(n=25)和来自平行队列的健康志愿者(n=25)中分析乳糜泻患者的血清,这些志愿者接受了未掩盖的麸质挑战。在摄入 10 克活力小麦麸质面粉后 2、4 和 6 小时采集血清;评估了 187 种细胞因子。通过高灵敏度电化学发光免疫分析法进行确认分析。细胞因子升高与症状相关。乳糜泻患者麸质挑战后的细胞因子释放包括白细胞介素-2(IL-2)、趋化因子(C-C 基序)配体 20(CCL20)、白细胞介素-6(IL-6)、趋化因子(C-X-C 基序)配体(CXCL)9、CXCL8、干扰素(IFN)-γ、白细胞介素-10(IL-10)、白细胞介素-22(IL-22)、白细胞介素-17A(IL-17A)、肿瘤坏死因子(TNF)-α、CCL2 和 Amphiregulin 的显著升高。IL-2 和 IL-17A 最早升高。细胞因子的峰值水平通常在 4 小时。IL-2 增加最多(中位数 57 倍),其次是 CCL20(中位数 10 倍)。细胞因子变化彼此之间强烈相关,症状最严重的患者升高幅度最大。乳糜泻患者麸质后早期升高的白细胞介素-2、白细胞介素-17A、白细胞介素-22 和干扰素-γ提示迅速激活的 T 细胞可能是其来源。麸质后细胞因子的释放可能有助于监测实验性治疗并支持诊断。
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