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    Reduced levels of circulating natural killer cells in children with celiac disease
    (Indonesian Pediatric Society Publishing House, 2020) Agin, M.; Sevinc, E.; Dogan, E.; Sevinc, N.
    Background Celiac disease (CD) is an autoimmune disease characterized by malabsorption. Serologic testing for CD consists of Ig A type of antitissue transglutaminase (tTG), antiendomysium (EMA). These tests are helpful in monitoring adherence to the gluten-free diet (GFD). Natural killer (NK) cell count alterations have been reported in various diseases, such as cancer, Crohn’s disease, malnutrition, and autoimmune disorders. Objective To compare peripheral blood NK cell counts in children with celiac disease (CD) to healthy controls. The second aim was to analyze for possible correlations between NK cells (CD3-/ CD16+, CD56+) and tissue transglutaminase (tTG)-IgA and tTG-IgG, as well as endomysial antibody EMA-IgA indicating . gluten sensitivity. Methods Fifty children with CD were compared to 48 healthy children as controls, with similar age and sex distribution. Peripheral blood NK cell counts were measured by flow cytometry. Results The median (P25-P75) ages of the 50 celiac patients (23 male; 46%) and 48 controls (21 male; 44%) were 10 (2-17) years and 9 (3-17) years, respectively. Mean follow-up duration was 3 years, ranging from 1-10 years. All CD patients had positive tTG-IgA and EMA-IgA tests. while it was negative in all (100 %) control patients. The absolute number of circulating CD16+ NK cells (259.52 vs. 1404.36 ?/L) and CD56+ NK cells (366.24 vs. 2440.46 ?/L) were significantly lower in the celiac group than the control group (P<0.05 for both). The absolute numbers of circulating white blood cells (7785 vs. 8165 ?/L) and lymphocytes (3106 vs. 3173 ?/L) were not significantly different between the celiac and control groups (P>0.05 for both). Correlation analysis between the absolute number of circulating NK cells and tTG-IgA, tTG-IgG, and EMA-IgA levels in CD patients revealed no significant relationships (P>0.05 for all). Conclusions Peripheral blood NK cell count are significantly lower in celiac patients than controls, hence, decreased NK cell counts may be an abnormal feature seen in autoimmune diseases. NK cell count in celiac patients has no significant correlations to tTG-IgA, tTG-IgG, or EMA-IgA levels. Therefore, NK cell count may be inappropriate marker for monitoring compliance to a gluten free diet. © 2020, Indonesian Pediatric Society Publishing House. All rights reserved.
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    The vitamin D status and serum eosinophilic cationic protein levels in infants with cow's milk protein allergy
    (E-Century Publishing Corporation, 2021) Dogan, E.; Sevinc, E.
    Eosinophil cationic protein (ECP) is a cytotoxic protein released from eosinophils. The level of ECP increases in some allergic diseases. Recently, vitamin D deficiency has been suggested to be a risk factor for childhood allergic disease. The first aim of the study is to measure the serum vitamin D levels and ECP in infants with cow's milk protein allergy (CMPA) and compare them with controls. The second aim of this study is to investigate whether vitamin D levels are correlated with ECP or not. Sixty-two infants with CMPA were compared to 58 healthy, similar to distribution of age and sex normal infants as controls. The serum ECP levels were detected by an immunoassay system. Serum 25(OH)D levels were measured by using an enzyme-linked immunoassay kit. Vitamin D deficiency was defined as a serum 25(OH)D level of < 10 ng/mL and sufficient 30 ng/mL. The median serum ECP level in the CMPA group was significantly higher than in the control group (51.45 and 17.55 ng/mL, respectively, P = 0.001). There were no significant differences between groups with regards to median 25(OH)D levels (29.31 ± 1.67 and 27.32 ± 1.41 ng/mL, respectively, P = 0.646). The serum 25(OH)D levels were under 30 ng/mL in 38 of infants with CMPA (61.2%) and in 32 of controls (55.1%). Correlation analysis between the serum 25(OH)D level and ECP of infants with CMPA have revealed no significant relation (P = 0.888). Our results do not support the hypothesis that vitamin D deficiency may be a risk factor for CMPA. © 2020 E-Century Publishing Corporation. All rights reserved.