engleski

CHROMOSOMAL ABERRATIONS IN PERIPHERAL BLOOD LYMPHOCYTES IN PATIENTS WITH NEWLY DIAGNOSED CELIAC AND CROHN’S

Objectives and Study: We have recently shown that paediatric patients with newly diagnosed celiac disease (CED) have an increased number of chromosomal aberrations in peripheral blood lymphocytes and that gluten-free diet has a significant lowering effect on their number (1, 2). Chronic inflammation and the chromosomal instability have been both linked to an increased risk of malignancy (3), and chronic gastrointestinal diseases such as CED and Crohn’s disease (CD) have also been associated with the elevated malignancy risk (4, 5). We have, therefore, decided to determine the number of chromosomal aberrations in peripheral blood lymphocytes in patients with newly diagnosed, untreated CD and CED. Methods: In the 2.5 years period (06/2006 to 12/2008) we included 44 patients in the study ; 19 patients with newly diagnosed CED (12/19 female, age range 1–16 y, mean 6.9 y) ; 13 patients with newly diagnosed CD before any treatment was started (9/13 female, age range 7–17 y, mean 12 y), and 12 healthy controls (8/12 female, age range 1–18 y, mean 8.5 y). CD and CED group did not differ compared to controls in regard to age and gender (P = 0.5, P = 0.07, P = 0.8, P = 0.9, respectively). Chromosome aberrations were analyzed in peripheral blood lymphocytes. For each subject 100 metaphases were analyzed for chromosome-type (breaks, gaps, exchange, acentric and dicentric fragments and ring chromosome) and chromatid-type aberrations (breaks, gaps, and chromatid exchange). A single cytogeneticist, who was blinded to the origin of the cells and was not involved in the treatment of the patients, performed the analyses. Results: In comparison to healthy controls (mean 4 aberrations/ 100 metaphases), a significantly increased overall number of aberrations was found in, both, CED (mean 6.8 aberrations/100 metaphases) and in CD group (mean 6.2 aberrations/100 metaphases) (P = 0.003, P = 0.04, respectively). Increased number of aberrant cells was also found in CED (mean 6.4) and CD (mean 5.5) group compared to controls (mean 4) (P = 0.002, P = 0.04, respectively). There was no statistically significant difference between CD and CED groups in regard to overall number of aberrations and aberrant cells (P = 0.47, P = 0.27, respectively). Conclusion: Patients with active CED and newly diagnosed CD, before treatment was initiated, have significantly increased number of chromosomal aberrations in peripheral blood lymphocytes. This could be the link between the chronic inflammation and the increased risk for malignancy in both disorders.

celiac disease; Crohn's disease; chromosomal aberrations

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