Gut microflora associated characteristics in children with celiac disease

Aim: The over-arching aim of this thesis was to study some metabolic functions of the gut microflora in children with known or screening detected celiac disease (CD) and their first-degree relatives.

Materials: Study I. A number of 36 untreated CD children, 47 after at least 3 months on glutenfree diet (GFD) and 42 healthy controls (HC). Study II. A number of 76 first-degree relatives to CD children and 93 healthy controls (HC). Study III. A number of 17 screening detected CD children were included to be compared with the untreated children and controls from study I; with exchange of one child in the untreated group, due to low age. Study IV. A comparative study regarding correlation between iso-forms of short chain fatty acids (SCFAs) in humans as well as in animals.

Methods: Faecal short chain fatty acids were measured in all four studies. Additionally faecal tryptic activity (FTA) was measured in study II.

Major findings: All groups of CD children demonstrated a similar SCFAs profile, i.e. significantly more total SCFAs and acetic acid and a strong tendency to more iso-butyric and iso-valeric acids compared with HC. The first-degree relatives demonstrated another SCFAs profile, i.e. significantly less total SCFAs and acetic acid and significantly more FTA than HC.

Conclusions and future outlook Based upon the strong similarities between all groups of CD children we are allowing ourselves hypothesising that CD children have a celiacogenic flora compared with healthy controls. In a similar way it can be said that the first-degree relatives are harbouring a celiacprotective microflora. Our findings open up for challenging new diagnostic, therapeutic and prognostic possibilities.

List of scientific papers

I. Tjellström B, Stenhammar L, Högberg L, Fälth-Magnusson K, Magnusson KE, Midtvedt T, Sundqvist T, Norin E (2005). "Gut microflora associated characteristics in children with celiac disease." Am J Gastroenterol 100(12): 2784-8
https://pubmed.ncbi.nlm.nih.gov/16393236

II. Tjellström B, Stenhammar L, Högberg L, Fälth-Magnusson K, Magnusson KE, Midtvedt T, Sundqvist T, Houlston R, Popat S, Norin E (2007). "Gut microflora associated characteristics in first-degree relatives of children with celiac disease." Scand J Gastroenterol 42(10): 1204-8
https://pubmed.ncbi.nlm.nih.gov/17852880

III. Tjellström B, Stenhammar L, Högberg L, Fälth-Magnusson K, Magnusson K-E, Midtvedt T, Sundqvist T, Norin E (2009). "Screening-detected and symptomatic untreated celiac children show similar gut microfloraassociated characteristics." (Manuscript)

IV. Cardona ME, Collinder E, Stern S, Tjellström B, Norin E, Midtvedt T (2005). "Correlation between faecal iso-butyric and iso-valeric acids in different species." Microbiol Ecol Health Dis 17: 177-82