PRE-AND POSTTREATMENT SERUM LEVELS OF CYTOKINES IL-1-BETA, IL-6, AND IL-1 RECEPTOR ANTAGONIST IN CELIAC-DISEASE - ARE THEY RELATED TO THE ASSOCIATED OSTEOPENIA

Objective: Decreased bone mineral density is a common finding in untre ated celiac disease patients. However, the precise pathophysiology of osteopenia remains incompletely understood. Pathological features of g luten sensitivity are associated with local release of proinflammatory and antiinflammatory cytokines. We investigated the serum levels of I L-1 beta, IL-6, and IL-1 receptor antagonist in celiac patients and co rrelated them with bone density measurements. Methods: We assessed ser um samples of 16 female patients at the time of diagnosis ton an unres tricted diet) and after a mean time of 37 months on a gluten-free diet . At the same time, bone mineral density in the lumbar spine and total skeleton was determined by DEXA. Results: Untreated patients had high serum levels of IL-1 beta and IL-6 and normal IL-1-RA. Treatment prod uced a decrease in median IL-1 beta levels (p = NS) and a significant diminution of IL-6 (p < 0.05). On the contrary, IL-1-RA increased sign ificantly after treatment (p < 0.05). Baseline lumbar spine Z-score an d IL-6 levels exhibited a significant inverse correlation (r = -0.61; p < 0.01). Patients with more severe baseline osteopenia (< -2 Z-score s) had a significantly lower IL-1-RA than those with less bone comprom ise (> -2 Z-scores). Conclusions: Our data demonstrate that the inflam matory process observed in active celiac disease is associated with hi gh serum levels of IL-1 beta and IL-6 and normal levels of IL-1-RA. Tr eatment significantly reduces both proinflammatory cytokines and signi ficantly increases the antiinflammatory one. We also suggest that thes e cytokines might have a role in the osteopenia associated with celiac disease. (C) 1998 by Am. Cell. of Gastroenterology.