LB052 - NON-CELIAC WHEAT SENSITIVITY (NCWS) IS ASSOCIATED WITH INCREASED SYSTEMIC AND INTESTINAL IMMUNE ACTIVATION

LB052

NON-CELIAC WHEAT SENSITIVITY (NCWS) IS ASSOCIATED WITH INCREASED SYSTEMIC AND INTESTINAL IMMUNE ACTIVATION

L. Filipe Rosa1,*, P. Petersen1, S. C. Bischoff1 on behalf of INDICATE-FH Consortium

1180A, University of Hohenheim, Stuttgart, Germany

 

Rationale: NCWS is an increasingly relevant clinical disease which, because of limited diagnostic markers, is mainly diagnosed by exclusion, ideally by double-blind placebo-controlled food challenge (DBPCFC). There is evidence that NCWS is associated with systemic immune activation and intestinal inflammatory response with increased immune cell infiltration in the intestinal mucosa.

Methods: 285 patients with non-IgE-related food allergies were recruited in a double-blind, randomized and controlled trial (INDICATE-FH). Wheat allergy and celiac disease were excluded by allergy diagnostics and 19 patients (age 50.06±6.1) suffering from NCWS as well as 18 controls (age 43.97±7.43) were identified by DBPCFC. Inflammatory markers were assessed using whole blood samples and duodenal biopsies collected during esophagogastroduodenoscopy.

Results: Whole blood analysis revealed that NCWS patients had increased total leukocyte counts (p=0.063) with differential blood counts indicating increased undifferentiated granulocytes (p=0.052) and neutrophils (p<0.05), while eosinophils, basophils and lymphocytes remained unchanged. Additionally, hematoxylin and eosin as well as immunohistochemical staining of duodenal biopsies demonstrated an increased count of intraepithelial lymphocytes (IELs)/100 epithelial cells along with enhanced lysozyme protein levels in NCWS patients compared to controls (p<0.05). 

Conclusion: Our data suggest that NCWS is associated systemic immune activation, characterized by elevated neutrophil granulocyte counts in peripheral blood. In addition, increased IEL numbers and enhanced lysozyme expression in the duodenum point towards increased intestinal immune activity.

 

German Clinical Trials Register (DRKS00029323)

Disclosure of Interest: None declared