부산대학교 도서관

Background The diagnosis of coeliac disease (CD) in individuals that have started a gluten-free diet (GFD) without an adequate previous diagnostic work-out is a challenge. Several immunological assays such as IFN-[gamma] ELISPOT have been developed to avoid the need of prolonged gluten challenge to induce the intestinal damage. We aimed to evaluate the diagnostic accuracy of activated gut-homing CD8.sup.+ and TCR[gamma][delta].sup.+ T cells in blood after a 3-day gluten challenge and to compare it with the performance of IFN-[gamma] ELISPOT in a HLA-DQ2.5 subsample. Methods A total of 22 CD patients and 48 non-CD subjects, all of them following a GFD, underwent a 3-day 10-g gluten challenge. The percentage of two T cell subsets (CD8.sup.+ CD103.sup.+ [beta]7.sup.hi CD38.sup.+/total CD8.sup.+ and TCR[gamma][delta].sup.+ CD103.sup.+ [beta]7.sup.hi CD38.sup.+/total TCR[gamma][delta].sup.+) in fresh peripheral blood drawn baseline and 6 days after the challenge was determined by flow cytometry. IFN-[gamma] ELISPOT assays were also performed in HLA-DQ2.5 participants. ROC curve analysis was used to assess the diagnostic performance of the CD8.sup.+ T cell response and IFN-[gamma] ELISPOT. Results Significant differences between the percentage of the two studied subsets of CD8.sup.+ and TCR[gamma][delta].sup.+ cells at days 0 and 6 were found only when considering CD patients (p < 10.sup.-3 vs. non-CD subjects). Measuring activated CD8.sup.+ T cells provided accurate CD diagnosis with 95% specificity and 97% sensitivity, offering similar results than IFN-[gamma] ELISPOT. Conclusions The results provide a highly accurate blood test for CD diagnosis in patients on a GFD of easy implementation in daily clinical practice. Keywords: CD8 T cells, Celiac disease, Gluten challenge, Gluten-free diet, IFN-[gamma] ELISPOT, Flow cytometry
Author(s): Fernando Fernández-Baéares[sup.1,2] , Natalia López-Palacios[sup.3] , María Corzo[sup.4] , Beatriz Arau[sup.1,2] , Mercedes Rubio[sup.4] , Marta Fernández-Prieto[sup.4] , Eva Tristán[sup.1,2] , Mar Pujals[sup.1] , Sergio Farrais[sup.5] , Saúl Horta[sup.4] [...]