RCD [refractory CD (coeliac disease)] is characterized by severe symptoms/signs of malabsorption and mucosal damage unresponsive to a GFD (gluten-free diet). The pathogenesis of RCD is not fully understood. In the present paper, we have characterized the mucosal profile of effector cytokines in RCD. Duodenal biopsies were taken from patients with RCD, patients with active CD and normal controls and were analysed for inflammatory cytokines by real-time PCR and ELISA. IFN (interferon)-γ and IL (interleukin)-21 transcripts were increased in active CD patients but not in RCD patients as compared with normal controls, whereas IL-17A RNA was up-regulated in both active CD and RCD. No significant increase in IL-15 transcripts was observed in both active CD and RCD, whereas IL-15 protein was increased in active CD. IL-6 and TNF (tumour necrosis factor)-α were up-regulated only in RCD. As a proof, we present the case of a woman affected by RCD who responded to anti-TNF-α treatment with improvement of malabsorptive symptoms/signs but no healing of mucosal lesions. The findings indicate that the profile of mucosal effector cytokines differs between RCD and active CD and suggest that TNF-α, IL-6 and IL-17A, but not Th1-type cytokines, could drive the detrimental response in this condition.
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Research Article|
November 25 2013
Analysis of the cytokine profile in the duodenal mucosa of refractory coeliac disease patients
Roberta Caruso;
Roberta Caruso
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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Irene Marafini;
Irene Marafini
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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Silvia Sedda;
Silvia Sedda
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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Giovanna Del Vecchio Blanco;
Giovanna Del Vecchio Blanco
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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Paolo Giuffrida;
Paolo Giuffrida
†Department of Internal Medicine, Fondazione IRCCS Policlinico, San Matteo, Università di Pavia, Pavia, Italy
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Thomas T. MacDonald;
Thomas T. MacDonald
‡Blizard Institute Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, U.K.
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Gino Roberto Corazza;
Gino Roberto Corazza
†Department of Internal Medicine, Fondazione IRCCS Policlinico, San Matteo, Università di Pavia, Pavia, Italy
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Francesco Pallone;
Francesco Pallone
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
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Antonio Di Sabatino;
Antonio Di Sabatino
†Department of Internal Medicine, Fondazione IRCCS Policlinico, San Matteo, Università di Pavia, Pavia, Italy
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Giovanni Monteleone
*Department of Systems Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
Correspondence: Professor Giovanni Monteleone (email Gi.Monteleone@Med.uniroma2.it).
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Publisher: Portland Press Ltd
Received:
August 08 2013
Revision Received:
September 23 2013
Accepted:
October 15 2013
Accepted Manuscript online:
October 15 2013
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2014 Biochemical Society
2014
Clin Sci (Lond) (2014) 126 (6): 451–458.
Article history
Received:
August 08 2013
Revision Received:
September 23 2013
Accepted:
October 15 2013
Accepted Manuscript online:
October 15 2013
Citation
Roberta Caruso, Irene Marafini, Silvia Sedda, Giovanna Del Vecchio Blanco, Paolo Giuffrida, Thomas T. MacDonald, Gino Roberto Corazza, Francesco Pallone, Antonio Di Sabatino, Giovanni Monteleone; Analysis of the cytokine profile in the duodenal mucosa of refractory coeliac disease patients. Clin Sci (Lond) 1 March 2014; 126 (6): 451–458. doi: https://doi.org/10.1042/CS20130478
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