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, 152 (1), 75-80

Differential Mucosal IL-17 Expression in Two Gliadin-Induced Disorders: Gluten Sensitivity and the Autoimmune Enteropathy Celiac Disease

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Differential Mucosal IL-17 Expression in Two Gliadin-Induced Disorders: Gluten Sensitivity and the Autoimmune Enteropathy Celiac Disease

Anna Sapone et al. Int Arch Allergy Immunol.

Abstract

Background: The immune-mediated enteropathy, celiac disease (CD), and gluten sensitivity (GS) are two distinct clinical conditions that are both triggered by the ingestion of wheat gliadin. CD, but not GS, is associated with and possibly mediated by an autoimmune process. Recent studies show that gliadin may induce the activation of IL-17-producing T cells and that IL-17 expression in the CD mucosa correlates with gluten intake.

Methods: The small-intestinal mucosa of patients with CD and GS and dyspeptic controls was analyzed for expression of IL-17A mRNA by quantitative RT-PCR. The number of CD3+ and TCR-gammadelta lymphocytes and the proportion of CD3+ cells coexpressing the Th17 marker CCR6 were examined by in situ small-intestinal immunohistochemistry.

Results: Mucosal expression of IL-17A was significantly increased in CD but not in GS patients, compared to controls. This difference was due to enhanced IL-17A levels in >50% of CD patients, with the remainder expressing levels similar to GS patients or controls, and was paralleled by a trend toward increased proportions of CD3+CCR6+ cells in intestinal mucosal specimens from these subjects.

Conclusion: We conclude that GS, albeit gluten-induced, is different from CD not only with respect to the genetic makeup and clinical and functional parameters, but also with respect to the nature of the immune response. Our findings also suggest that two subgroups of CD, IL-17-dependent and IL-17-independent, may be identified based on differential mucosal expression of this cytokine.

Figures

Fig. 1
Fig. 1
Representative microphotographs of mucosal CD3 expression in a dyspeptic control patient (a), a gluten-sensitive (GS) patient (b) and a celiac disease (CD) patient with active disease (c) (40× magnification).
Fig. 2
Fig. 2
Mucosal IL-17A mRNA expression in the 3 groups. IL-17A expression is significantly increased in CD patients (n = 13) compared to controls (n = 7; p = 0.024) and GS patients (n = 11; p = 0.03).
Fig. 3
Fig. 3
Representative immunofluorescence staining of mucosal CD3 (FITC; green) and CCR6 (Alexa Fluor® 568; red) in a control subject (a) and a CD patient expressing high levels of mucosal IL-17A (b). Shown are merged confocal microscopy images (60× magnification) in which cells expressing both markers appear yellow. Nuclei were counterstained in blue with TO-PRO®-3 (Molecular Probes).

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