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Paediatric coeliac disease and dermatitis herpetiformis: differences in complement activation in relation to diet
A Cefalo1, M Pietrogrande, G Schiavo
1Istituto di Medicina Interna, Università di Milano.
Bollettino Dell'Istituto Sieroterapico Milanese
|January 1, 1989
Summary
Complement system involvement differs between pediatric coeliac disease (CD) and dermatitis herpetiformis (DH). Gluten-free diets impact complement levels and correlate with reduced intestinal damage in CD patients.
Area of Science:
- Immunology
- Gastroenterology
- Dermatology
Background:
- The role of the complement system in pediatric coeliac disease (CD) and dermatitis herpetiformis (DH) requires further elucidation.
- Understanding complement's involvement is crucial for deciphering the pathogenesis of these conditions.
Purpose of the Study:
- To investigate complement (C') system involvement in pediatric CD and DH.
- To correlate complement parameters with enteric mucosal lesions and function in relation to dietary interventions.
Main Methods:
- Studied 50 children with CD and 42 with DH, divided into three dietary groups: free diet, gluten-free diet (GFD), and post-gluten reintroduction.
- Assessed complement parameters (C3, C4, C3d/C3 ratio, circulating immune complexes).
- Evaluated enteric histological lesions and correlated findings with complement levels.
Main Results:
- Significant modifications in complement parameters were observed primarily in CD patients.
- C3 and C4 levels increased during GFD in CD and inversely correlated with histological lesion scores.
- The C3 catabolic index (C3d/C3 ratio) decreased in CD patients on GFD, correlating positively with histological scores.
- Circulating immune complexes were higher in DH, but decreased in CD patients on GFD.
Conclusions:
- Suggests distinct pathogenetic mechanisms involving the complement system in pediatric CD and DH.
- Dietary gluten significantly influences complement system activity and its relationship with intestinal pathology in CD.