Detection Of Celiac Disease Susceptible Genes And Serum Specific Antibodies In Children With Related Symptoms In Shenyang

Objective: Celiac Disease(CD)is an autoimmune enteropathy caused by intestinal autoimmune damage caused by gluten ingested in individuals with genetic susceptibility.The HLA-DQ2/-DQ8 receptor on the surface of antigen-presenting cells presents gluten proteins that are not completely metabolized to lymphocytes,which release cytokines to cause damage to intestinal mucosa atrophy,crypt hyperplasia,inflammatory cell infiltration,etc.Some column-specific autoantibodies.After the diagnosis of CD,the most effective treatment is to start the gluten free diet(GFD)immediately.Most patients can improve the clinical symptoms through GFD and repair the damaged small intestinal mucosa.The "gold standard" for the diagnosis of CD is small bowel tissue biopsy,and serum antibody and genotyping can also be used for assisted screening.If CD patients do not receive treatment for a long time,a variety of complications will occur,causing serious effects.Children are at a critical stage of growth and development,and if left to progress,the CD may have serious and long-term effects.Active measures should be taken from the time of childhood,timely diagnosis and treatment will prevent CD from unpredictable risks to children's growth and development.Because of concerns earlier in the world,there are many related researches and reports on CD,but the domestic understanding of CD is still very limited.Only a few cases are reported or retrospectively analyzed.The patients currently found may be only the tip of the iceberg.Therefore,the aim of this study was to investigate the portability and detection of susceptibility genes and specific autoantibodies in children with one or more CD-related enteral and parenteral symptoms,and to screen and analyze suspected CD cases,suggesting clinical Improve the need for CD related inspections.Methods: 152 pediatric patients who had one or more symptoms of CD and 26 healthy or without symptoms of CD were collected during July 2018 to September 2018,with a range of age from 0.5 to 15 years old.Later,the prevalence of HLA-DQ2/-DQ8 was determined by examining the blood samples of them using an DNA microarray method.ELISA methods were performed on anti-GAF and anti-tTG antibodies,while IIFs were used to test anti-EMA antibodies.Statistics of the differences of gene and antibody prevalence between the two groups was carried out using SPSS software 24.0 through Chi-square analysis,in which a p value less than 0.05 meant the difference was significant.Results: 44 children out of the 152 symptom group were tested HLA-DQ2/-DQ8 positive with a carrying rate of 28.95%,a little higher than control group,which was 19.23% for control group(p=0.352).The overall prevalence of 6 types of antibodies is 17.76%(27/152),while the it is 0%(0/26)in control group.Anti-EMA,including IgG and IgA,was tested to be positive with a proportion of 12.5%(19/152),while for Anti-tTG and Anti-GAF,the positive rates were same to be 2.63%(4/152).When testing the combination of all these antibodies,there was a significant difference between two groups(p=0.0158)with an overall prevalence of 17.76%.In the symptom group,there were 7 children carrying HLA-DQ2/-DQ8 had one or more types of autoantibodies at the same time.These children with both gene and autoantibody positive should be treated as suspected CD patients,who accounted for a proportion of 4.6% of the whole symptom group,while 0%(0/26)was found in control group(p=0.596).15.9%(7/44)in gene positive children(n=44)of symptom group were found to be suspected CD and it is significant higher than that in control group(p=0.038).Among the 7 suspected cases,the clinical manifestations were 3 cases of unexplained abdominal pain,2 cases of short stature,1 case of vomiting and 1 case of dyspepsia,all of which were typical CD symptoms.Conclusion: Children in this region have high HLA-DQ2/-DQ8 gene carrying rate and have certain CD genetic susceptibility.Simultaneous detection of HLA-DQ2/-DQ8 gene and serum-specific antibodies can help detect suspected CD cases in children with CDrelated symptoms and improve clinical understanding of the disease.