γδ plus T-Cells Is a Useful Biomarker for the Differential Diagnosis between Celiac Disease and Non-Celiac Gluten Sensitivity in Patients under Gluten Free Diet

被引：4

作者：

Martin-Cardona, Albert ^{[1
,2
]}

Carrasco, Anna ^{[1
,2
]}

Arau, Beatriz ^{[1
,2
]}

Vidal, Judith ^{[3
]}

Tristan, Eva ^{[1
,2
]}

Ferrer, Carme ^{[4
]}

Gonzalez-Puglia, Gerardo ^{[1
]}

Pallares, Natalia ^{[5
]}

Tebe, Cristian ^{[5
]}

Farrais, Sergio ^{[6
]}

Nunez, Concepcion ^{[7
]}

Fernandez-Banares, Fernando ^{[1
,2
]}

Esteve, Maria ^{[1
,2
]}

机构：

[1] Univ Barcelona, Hosp Univ Mutua Terrassa, Gastroenterol Dept, Terrassa 08221, Spain

[2] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Salud Carlos III, CIBERehd, Madrid 28029, Spain

[3] Catlab, Dept Flow Cytometry, Viladecavalls 08232, Spain

[4] Univ Barcelona, Hosp Univ Mutua Terrassa, Pathol Dept, Terrassa 08221, Spain

[5] Germans & Trias Pujol Res Inst & Hosp IGTP, Biostat Support & Res Unit, Badalona 08916, Spain

[6] Hosp Univ Fdn Jimenez Diaz, Gastroenterol Dept, Madrid 28040, Spain

[7] Hosp Clin San Carlos, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Lab Invest Genet Enfermedades Complejas, Madrid 28040, Spain

来源：

NUTRIENTS | 2024年 / 16卷 / 14期

关键词：

celiac disease; non-celiac gluten sensitivity; gluten-free diet; intraepithelial lymphogram; gamma delta T cells; flow cytometry; INTRAEPITHELIAL LYMPHOCYTES; UPDATE;

D O I：

10.3390/nu16142294

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background: The differential diagnosis between patients with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) is difficult when a gluten-free diet (GFD) has been initiated before the diagnostic work-up. Isolated increases in TCR gamma delta+ and celiac lymphogram (increased TCR gamma delta+ plus decreased CD3-) may enable differential diagnosis in this challenging clinical setting. This study evaluated: (1) the accuracy of %TCR gamma delta+ and celiac lymphogram for diagnosing CD before and after GFD and for differentiation with NCGS; (2) TCR gamma delta+ kinetics at baseline and after starting GFD in both CD and NCGS. Methods: The inclusion criteria were patients with CD (n = 104), NCGS (n = 37), and healthy volunteers (n = 18). An intestinal biopsy for intraepithelial lymphogram by flow cytometry was performed at baseline and after GFD. The optimal cutoff for CD diagnostic accuracy was established by maximizing the Youden index and via logistic regression. Results: %TCR gamma delta+ showed better diagnostic accuracy than celiac lymphogram for identifying CD before and after GFD initiation. With a cutoff > 13.31, the accuracy for diagnosing CD in patients under GFD was 0.88 [0.80-0.93], whereas the accuracy for diagnosing NCGS (%TCR gamma delta+ <= 13.31) was 0.84 [0.76-0.89]. The percentage of TCR gamma delta+ cells showed differential kinetics between CD (baseline 22.7% [IQR, 16.4-33.6] vs. after GFD 26.4% [IQR, 17.8-36.8]; p = 0.026) and NCGS (baseline 9.4% [IQR, 4.1-14.6] vs. after GFD 6.4% [IQR, 3.2-11]; p = 0.022). Conclusion: TCR gamma delta+ T cell assessment accurately diagnoses CD before and after a GFD. Increased TCR gamma delta+ was maintained in the long term after GFD in CD but not in NCGS. Altogether, this suggests the potential usefulness of this marker for the differential diagnosis of these two entities in patients on a GFD.

引用

页数：17

共 40 条

[1] European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders [J].