Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Gastroenterol. 2021 Dec 11;21(1):462. doi: 10.1186/s12876-021-02056-1.
Coronavirus disease 2019 (COVID-19) is defined as an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 and celiac disease (CD) is one of the autoimmune multiorgan diseases, which can be accompanied by an increased risk of viral infections. CD patients, especially untreated subjects, may be at greater risk of infections such as viral illnesses. Interleukin (IL)-6, CD4, CD25, and FOXP3 are known as genes affecting immune homeostasis and relate to the inflammation state. This study aimed to compare the expression levels of aforementioned genes in peripheral blood samples of CD and severe COVID-19 patients.
Sixty newly diagnosed CD patients with median age (mean ± SD) of 35.40 ± 24.12 years; thirty confirmed severe COVID-19 patients with median age (mean ± SD) of 59.67 ± 17.22, and 60 healthy subjects with median age (mean ± SD) of 35.6 ± 13.02 years; were recruited from March to September 2020. Fresh whole blood samples were collected, total RNA was obtained and cDNA synthesis was carried out. RNA expression levels of IL-6, CD4, CD25, and FOXP3 genes were assessed using real-time quantitative RT-PCR according to the 2 formula. Statistical analysis was performed using SPSS (V.21) and GraphPad, Prism (V.6).
While increased expression of CD4, CD25, and FOXP3 was observed in CD patients compared to the control group (p = 0.02, p = 0.03, and p < 0.0001 respectively) and COVID-19 patients group (p < 0.0001 for all of them), their expression levels in COVID-19 patients decreased compared to controls (p < 0.0001, p = 0.01, p = 0.007, respectively). Increased IL-6 expression was observed in both groups of patients compared to controls (p < 0.0001 for both of them).
Although untreated CD patients may be at greater risk of developing into severe COVID-19 if they are infected by SARS-CoV-2 virus (due to their high expression of IL-6), increased expression of anti-inflammatory markers in these patients may be beneficial for them with the ability of reducing the severity of COVID-19 disease, which needs to be proven in future studies involving celiac patients infected with COVID-19.
2019 年冠状病毒病（COVID-19）被定义为一种由严重急性呼吸系统综合征冠状病毒 2 引起的新发传染病，而乳糜泻（CD）是一种自身免疫性多器官疾病，可伴有病毒感染风险增加。CD 患者，尤其是未经治疗的患者，可能更容易感染病毒等疾病。白细胞介素（IL）-6、CD4、CD25 和 FOXP3 是已知影响免疫稳态并与炎症状态相关的基因。本研究旨在比较 CD 和重症 COVID-19 患者外周血样本中上述基因的表达水平。
2020 年 3 月至 9 月期间，共招募了 60 名新诊断的 CD 患者（中位年龄（均值±标准差）为 35.40±24.12 岁）；30 名确诊的重症 COVID-19 患者（中位年龄（均值±标准差）为 59.67±17.22 岁）和 60 名健康受试者（中位年龄（均值±标准差）为 35.6±13.02 岁）。采集新鲜全血样本，提取总 RNA，并进行 cDNA 合成。采用实时定量 RT-PCR 根据 2 个公式评估 IL-6、CD4、CD25 和 FOXP3 基因的 RNA 表达水平。使用 SPSS（V.21）和 GraphPad，Prism（V.6）进行统计分析。
与对照组相比，CD 患者的 CD4、CD25 和 FOXP3 表达增加（p=0.02，p=0.03 和 p<0.0001 分别），与 COVID-19 患者组相比（所有 p<0.0001），而 COVID-19 患者组的表达水平则低于对照组（p<0.0001，p=0.01，p=0.007，分别）。两组患者的 IL-6 表达均高于对照组（两者均 p<0.0001）。
尽管未经治疗的 CD 患者如果感染 SARS-CoV-2 病毒，可能更容易发展为重症 COVID-19（由于他们的 IL-6 高表达），但这些患者中抗炎标志物的高表达可能对他们有益，有助于降低 COVID-19 疾病的严重程度，这需要在未来涉及感染 COVID-19 的乳糜泻患者的研究中进一步证实。
