Objective: We aimed to investigate the mucosal activation of a broad range of genes associated with the Th17 signalling pathway in children at different stages of CD; including children with increased risk for CD, children with untreated and gluten-free diet (GFD)-treated CD.
Material & methods:Small intestinal biopsies were taken from children with untreated and GFDtreated CD, transglutaminase antibody (TGA) positive children with potential CD and reference children. Real-time PCR-arrays were used to study the gene expression pattern of Th17 related genes and qPCR was used to study the IL-17A expression.
Results:The mucosal expression of CD8A was elevated at all stages of CD. Children with untreated CD had diminished levels of IL-17RE, IL-23R, RORc, STAT6, CCL22, NFATC2, IL-18, CD4, CD247 and matrix metalloproteinase(MMP)9, but elevated levels of MMP3, IL-17, IFN- and CD8A, compared to references. The majority of the aforementioned genes, being differentially expressed in untreated CD, displayed similar expression in GFD-treated children and references.Children with untreated and GFD-treated CD had elevated expression of IFN-, but reduced expression of CD247. Interestingly, children with potential CD displayed reduced FOXP3, IL-21 and IL-17A levels.
Conclusion:Mucosal up-regulation of Th17 immunity occurs at the late stage of disease and is down-regulated with dietary treatment indicating that IL-17 immunity is not a fundamental feature of CD as Th1 immunity, which is not fully down-regulated by GFD.