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  4. The role of cytokines and iron in the long term management of coeliac disease

The role of cytokines and iron in the long term management of coeliac disease

Principal Investigators: Dr T Iqbal and Dr C Tselepis

Institution: University of Birmingham

Research classifcation: Management of coeliac disease and dermatitis herpetiformis

Project completion: 2006

Grant awarded: £30K

Iron deficiency anaemia can be a symptom of undiagnosed coeliac disease, however despite conforming to a gluten-free diet many patients remain iron deficient. The aim of this research project was to determine whether specialised cells within the intestinal wall were responsible for causing iron deficiency and if so, how this information could be used to develop medicines, which in the future could prevent iron deficiency anaemia in patients with coeliac disease.

The specialised cells in the intestinal wall are called lymphocytes and they produce proteins called cytokines. These cytokines, in turn, are able to alter proteins responsible for absorbing iron in the intestinal wall. Consequently, the patient is unable to absorb iron effectively, even when consuming adequate iron in the diet.

Biopsy samples were taken from the small bowel of patients without coeliac disease (controls) and those with treated and untreated coeliac disease, either with or without anaemia. Samples from the small bowel of both treated and untreated coeliac disease patients had elevated levels of proteins compared with control samples. These results confirmed that there is a potential for ongoing anaemia even when following a strict gluten-free diet.

Ongoing anaemia can cause symptoms such as chronic tiredness, shortness of breath and a poorer quality of life. The results from this study will be useful in developing medicines which would prevent iron deficiency in patients with coeliac disease who are adhering to a gluten-free diet and help to restore a normal quality of life to these individuals.

Associated publications:

Sharma N, Laftah AH, Brookes MJ, et al. 2005 A role for tumour necrosis factor alpha in human small bowel iron transport. Biochem J. Sep 1;390(Pt2) 437-46.

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