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Gluten-Free Diet Induces Rapid Changes in Phenotype and Survival Properties of Gluten-Specific T Cells in Celiac Disease.

Gastroenterology
July 1, 2024
Louise F Risnes et al. (7 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to examine how gluten-specific T cells transition into memory T cells and how clinically relevant biomarkers normalize during the first year of a gluten-free diet in celiac disease patients.

Results Summary

The study found that gluten-specific CD4+ T cells peaked in blood at day 14, then decreased within 10 weeks of a gluten-free diet, with rapid changes in T-cell phenotype and disease-specific antibodies. These changes suggest a shift to a quiescent but chronic state in treated celiac disease.

Population

17 celiac disease patients (with additional assessments in subsets of 6 and 9 patients).

Effective Dosage

Not specified (gluten-free diet adherence).

Duration

1 year (with some assessments within the first 3 weeks).

Interactions

None mentioned.

Extracted Claims (14)
InterventionDirectionEndpointPopulationDosageImpactClaim #
gluten-free diet (GFD)
decrease
gut inflammation
celiac disease (CeD) patients
-
normalizes
#1
gluten-free diet (GFD)
decrease
disease-specific antibodies
celiac disease (CeD) patients
-
normalizes
#2
gluten-free diet (GFD)
increase
gluten-specific CD4+ T cells in blood
CeD patients
day 14
peaked
#3
gluten-free diet (GFD)
increase
Bcl-2
CeD patients
-
up-regulating
#4
gluten-free diet (GFD)
decrease
Ki-67
CeD patients
-
down-regulating
#5
gluten-free diet (GFD)
decrease
gluten-specific CD4+ T cells
CeD patients
within 10 weeks
decreased in frequency
#6
gluten-free diet (GFD)
decrease
CD38 in gluten-specific cells
CeD patients
within 3 days
decreased
#7
gluten-free diet (GFD)
decrease
ICOS in gluten-specific cells
CeD patients
within 3 days
decreased
#8
gluten-free diet (GFD)
decrease
HLA-DR in gluten-specific cells
CeD patients
within 3 days
decreased
#9
gluten-free diet (GFD)
decrease
Ki-67 in gluten-specific cells
CeD patients
within 3 days
decreased
#10
gluten-free diet (GFD)
no change
PD-1 expression
CeD patients
even after 12 months
persisted
#11
gluten-free diet (GFD)
no change
CD39 expression
CeD patients
even after 12 months
persisted
#12
gluten-free diet (GFD)
no change
OX40 expression
CeD patients
even after 12 months
persisted
#13
gluten-free diet (GFD)
decrease
IgA-transglutaminase 2
CeD patients
within 4 weeks
decreased significantly
#14
Abstract

BACKGROUND & AIMS: The treatment of celiac disease (CeD) with gluten-free diet (GFD) normalizes gut inflammation and disease-specific antibodies. CeD patients have HLA-restricted, gluten-specific T cells persisting in the blood and gut even after decades of GFD, which are reactivated and disease driving upon gluten exposure. Our aim was to examine the transition of activated gluten-specific T cells into a pool of persisting memory T cells concurrent with normalization of clinically relevant biomarkers during the first year of treatment. METHODS: We followed 17 CeD patients during their initial GFD year, leading to disease remission. We assessed activation and frequency of gluten-specific CD4+ blood and gut T cells with HLA-DQ2.5:gluten tetramers and flow cytometry, disease-specific serology, histology, and symptom scores. We assessed gluten-specific blood T cells within the first 3 weeks of GFD in 6 patients and serology in an additional 9 patients. RESULTS: Gluten-specific CD4+ T cells peaked in blood at day 14 while up-regulating Bcl-2 and down-regulating Ki-67 and then decreased in frequency within 10 weeks of GFD. CD38, ICOS, HLA-DR, and Ki-67 decreased in gluten-specific cells within 3 days. PD-1, CD39, and OX40 expression persisted even after 12 months. IgA-transglutaminase 2 decreased significantly within 4 weeks. CONCLUSIONS: GFD induces rapid changes in the phenotype and number of gluten-specific CD4+ blood T cells, including a peak of nonproliferating, nonapoptotic cells at day 14. Subsequent alterations in T-cell phenotype associate with the quiescent but chronic nature of treated CeD. The rapid changes affecting gluten-specific T cells and disease-specific antibodies offer opportunities for clinical trials aiming at developing nondietary treatments for patients with newly diagnosed CeD.

Medical Subject Headings (MeSH)
HumansCeliac DiseaseDiet, Gluten-FreeGlutensMaleFemaleAdultPhenotypeMiddle AgedCD4-Positive T-LymphocytesProtein Glutamine gamma Glutamyltransferase 2HLA-DQ AntigensGTP-Binding ProteinsLymphocyte ActivationTransglutaminasesBiomarkersProto-Oncogene Proteins c-bcl-2Memory T CellsTime FactorsYoung AdultTreatment OutcomeIntestinal Mucosa
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations6
Citations/Year6.0
Relative Citation Ratio1.98
Research Impact Scores
APT Score0.50
Weight Score1.45
Normalized Score0.70
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