Screening-detected and symptomatic untreated celiac children show similar gut microflora-associated characteristics

Abstract

Objective. The aim of this study was to investigate the metabolic function of intestinal microflora in children with screening-detected celiac disease (CD) to see if there is an aberrant gut flora in screening-detected CD similar to symptomatic CD and contrary to healthy controls. Materials and methods. As part of a Swedish multicenter screening for CD, 912 12-year-old children were screened with serum anti-human tissue transglutaminase-IgA. Small bowel biopsy specimens from children with positive serology revealed 17 individuals with CD. The functional status of the intestinal microflora was evaluated by gas–liquid chromatography of short chain fatty acids (SCFAs) in fecal samples. Our previously published findings in children with symptomatic CD and healthy controls were used as comparison. Results. The children with screening-detected CD had a similar fecal SCFA profile to children with symptomatic CD, but differed significantly from that in healthy children. Conclusions. This is the first study on SCFA patterns in fecal samples from children with screening-detected CD. The similarity of the fecal SCFA profile in screening-detected and symptomatic CD indicates common pathogenic mechanisms. This could open the way for new therapeutic or prophylactic measures based on novel biological principles.

Key Words::

• Celiac disease
• children
• screening
• short chain fatty acids

Acknowledgements

We express our sincere gratitude to research nurses Gudrun Hellgren and Ann-Catrin Andersson and the staff at the Pediatric Clinic in Norrköping for their help in collecting the fecal samples, and to Anna-Karin Persson at Karolinska Institute for excellent analytical work with the fecal samples. The study was financially supported by the Swedish Research Council (Medicine), FORSS (the Health Research Council in the south-east of Sweden), FORMAS (the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning) and the Bengt E Gustafsson Fund.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.