Transthyretin: a marker for celiac disease activity

Area of Science:

• Gastroenterology
• Clinical Nutrition
• Pediatric Medicine

Background:

• Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
• Assessing CD activity typically involves intestinal biopsy and serological markers like anti-endomysial antibodies.
• Transthyretin (TTR), a nutritional marker, has potential as a marker for CD activity.

Purpose of the Study:

• To evaluate the utility of Transthyretin (TTR) as a marker of celiac disease (CD) activity.
• To compare TTR levels with established markers of CD, including histological intestinal atrophy and anti-endomysial antibody titers.
• To assess TTR's correlation with disease activity and its potential role in monitoring dietary compliance.

Main Methods:

• Transthyretin (TTR) levels were measured in 26 active CD patients (gluten diet), 22 inactive CD patients (gluten-free diet), and 65 healthy controls.
• Celiac disease (CD) activity was assessed via intestinal biopsy for histological atrophy and anti-endomysial antibody titers.
• Statistical analysis compared TTR levels across groups and correlated them with established CD activity markers.

Main Results:

• Transthyretin (TTR) levels were significantly lowest in active celiac disease (CD) patients consuming gluten (r = 0.7, p < 0.002).
• TTR levels showed an inverse correlation with the degree of mucosal atrophy (r = 0.6, p < 0.005) and anti-endomysial antibody titers (p < 0.005).
• These findings indicate a strong association between TTR levels and both morphologic and serologic markers of CD activity.

Conclusions:

• Transthyretin (TTR) levels correlate with established markers of celiac disease (CD) activity.
• TTR can serve as a systemic parameter for assessing CD activity in patients.
• TTR measurement may aid in evaluating suspected CD cases and monitoring adherence to a gluten-free diet.