BETA-2-MICROGLOBULIN LEVELS IN CELIAC-DISEASE

The serum levels of β2-microglobulins β2-m) were studied in 65 celiac children. Significant statistical differences (p < 0.05) were found between the values of patients on a gluten-containing diet (mean ± SD,1.92 ± 0.64mg/L) and those on a gluten-free diet for less than (mean ± SD, 2.38 ± 0.76 mg/L) or greater than (mean ± SD, 1.46 ± 0.77 mg/L) 8 months. A significant difference was also found between the first group and the 15-subject control group, who underwent intestinal biopsy for low stature or chronic diarrhea but had normal intestinal mucosa (mean ± SD, 1.56 ± 0.42 mg/L). Serum β2-m levels were above normal values β2mg/L) in 10 of 26 (38.5%) celiac patients on a gluten-containing diet and in two of 15 (13.3%) subjects of the control group. The β2-m values of patients on a gluten-free diet for ≤8 months were significantly different (p < 0.001) from those of patients on a gluten-free diet for >8 months, as well from those of the control group. No significant differences were found between patients on a gluten-free diet for >8 months and the control group. A significant correlation between the anti-gliadin antibody (AGA) IgA and β2-m in the patients on a gluten-free diet for >8 months and control-group patients was found. The significant statistical difference (p < 0.05) of the mean values of β2-m between patients with DR3 + /DR7-and DR3 + /DR7 + phenotypes (if confirmed by a wider case study) could indicate a genetic heterogeneity of celiac disease. The β2-m, because of its specificity (86.7%), even if the sensitivity (38.5%) is not high, could be used with AGA to select candidates for intestinal biopsy. The increase of β2-m serum levels in the first months of the gluten-free diet is probably due to active regeneration of the intestinal mucosa. As the time necessary for serum values being normal is about 8 months, this could be the gluten-free period necessary before proceeding to a second biopsy. © 1990 Raven Press, Ltd., New York.