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01-12-2021 | Celiac Disease | Research article

Activated gut-homing CD8⁺ T cells for coeliac disease diagnosis on a gluten-free diet

Authors: Fernando Fernández-Bañares, Natalia López-Palacios, María Corzo, Beatriz Arau, Mercedes Rubio, Marta Fernández-Prieto, Eva Tristán, Mar Pujals, Sergio Farrais, Saúl Horta, Juana María Hernández, Marta Gomez-Perosanz, Pedro A. Reche, María Esteve, Concepción Núñez

Published in: BMC Medicine | Issue 1/2021

Abstract

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-γ 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⁺ and TCRγδ⁺ T cells in blood after a 3-day gluten challenge and to compare it with the performance of IFN-γ 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⁺ CD103⁺ β7^hi CD38⁺/total CD8⁺ and TCRγδ⁺ CD103⁺ β7^hi CD38⁺/total TCRγδ⁺) in fresh peripheral blood drawn baseline and 6 days after the challenge was determined by flow cytometry. IFN-γ ELISPOT assays were also performed in HLA-DQ2.5 participants. ROC curve analysis was used to assess the diagnostic performance of the CD8⁺ T cell response and IFN-γ ELISPOT.

Results

Significant differences between the percentage of the two studied subsets of CD8⁺ and TCRγδ⁺ cells at days 0 and 6 were found only when considering CD patients (p < 10⁻³ vs. non-CD subjects). Measuring activated CD8⁺ T cells provided accurate CD diagnosis with 95% specificity and 97% sensitivity, offering similar results than IFN-γ 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.

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Title: Activated gut-homing CD8+ T cells for coeliac disease diagnosis on a gluten-free diet
Authors: Fernando Fernández-Bañares
Natalia López-Palacios
María Corzo
Beatriz Arau
Mercedes Rubio
Marta Fernández-Prieto
Eva Tristán
Mar Pujals
Sergio Farrais
Saúl Horta
Juana María Hernández
Marta Gomez-Perosanz
Pedro A. Reche
María Esteve
Concepción Núñez
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Celiac Disease
Celiac Disease
Published in: BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-021-02116-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Activated gut-homing CD8⁺ T cells for coeliac disease diagnosis on a gluten-free diet

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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