Resultados de investigación

Background Diagnosis of celiac disease (CD) remains challenging in individuals already on a gluten-free diet (GFD). Although several alternative methods have been proposed, they have limitations. Identifying inflammation-related proteins that rapidly respond to gluten exposure in blood may offer diagnostic alternatives. Objective To characterize the inflammatory protein response to gluten in patients with CD on a GFD, and to assess the diagnostic potential of candidate biomarkers and their association with clinical symptoms. Methods Seventeen patients with CD and 15 non-CD individuals on a GFD (≥ 1 month) consumed 10 g of gluten. Serum, plasma and clinical symptoms were collected at baseline and 4 h post-gluten ingestion to assess changes in 92 inflammation-related proteins. Results Following gluten consumption, 18 proteins changed significantly only in patients with CD. Six showed an AUC ≥80%, and CCL20 achieved 85.7% sensitivity and 92.7% specificity for CD diagnosis. CCL20 level increases post-gluten challenge were higher in patients with vomiting but were also observed in those with absent or mild symptoms. Conclusion Gluten reintroduction triggers alterations in the inflammation-related protein profile of patients with CD. CCL20 emerges as a promising diagnostic candidate, its increase in plasma or serum, with low dependence on symptom presentation, may complement existing diagnostic approaches.