engleski

Chromosomal aberrations in children with coeliac disease (CD): Results of the follow-up study after a gluten-free diet

Background. We have recently shown that children with CD have significantly increased number of chromosomal aberrations in peripheral blood lymphocytes compared to healthy controls. However, this chromosomal instability, which could be related to well-known predisposition to cancer in CD patients, may be a primary, genetically determined abnormality, or a secondary phenomenon due to chronic enteropathy. Aim. We have, therefore, decided to follow the group of children with CD and with known frequency of chromosomal aberrations at the time of initial disease presentation, and to measure the same variable after a minimum of two years of the gluten-free diet. Patients and methods. Small intestinal biopsy, antiendomysial antibodies (EMA), and chromosomal aberrations in peripheral blood lymphocytes were repeated in 16 patients with CD (diagnosis based on the typical small bowel biopsy finding, positive EMA, and clinical recovery on the gluten-free diet) on the follow-up examination, after at least 24 months of the gluten-free diet (mean: 33 months). The mean frequency of aberrant cells on the gluten-free diet was compared with the initial finding on the gluten-containing diet, and also with mean frequency of the aberrant cells in the healthy control group. The differences were tested using t-test for small samples. Results. On the follow-up, the mean percentage of aberrant cells in the whole group (16/16), irrespective of the second biopsy and EMA finding, was 0.56% which is: i. significantly lower (p<0.05) compared to the initial frequency of 1.44% on the gluten-containing diet; ii.not significantly different from the frequency of 0.27% in the healthy control group (p> 0.05). Moreover: i. in 13/16 patients, who on the follow-up had normal small intestinal biopsy and negative EMA, the mean frequency of aberrant cells decreased from 1.54% to 0.38% (p<0.05); ii. in 3/16 patients, who on the follow-up had abnormal biopsy and positive EMA, and therefore were certainly not strictly following the gluten-free diet, the mean frequency of aberrant cells increased from 1% on the initial presentation to 1.33% on the follow-up (p>0.05). Conclusion.The frequency of chromosomal aberrations in peripheral blood lymphocytes of CD patients decreased significantly on the gluten-free diet, and therefore, this genomic instability is a secondary phenomenon, probably due to the chronic inflammation.

children; coeliac disease; chromosomal aberrations; gluten-free diet

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