Abstract

Background and Aims Neurotensin (NT) is a gut hormone secreted by specific endocrine cells scattered throughout the epithelial layer of the small intestine, which has been identified as an important mediator in several gastrointestinal functions and disease conditions. Its potential involvement in celiac disease (CD) has been investigated, but there are conflicting findings. The aim of this study was to evaluate serum NT levels in children with CD at diagnosis, compared to a control group, and to investigate whether NT correlated in CD patients with symptoms, antibody response, and intestinal mucosal damage. Materials and Methods. Children (1-16 years old) undergoing gastrointestinal endoscopy for CD or for other clinical reasons were included in this study. Patients with CD diagnosed according to the 2012 European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines without biopsy were also recruited. Fasting serum samples were analyzed for NT levels using ELISA. Logistic regression, Wilcoxon rank sum, and Spearman's rank tests were used for statistical analysis. Results Thirty children (18 females, 2.2-15.9 years old) were enrolled. Of 25 patients who underwent endoscopy, 9 were CD patients, 13 were controls, and 3 were excluded due to nonspecific inflammation at duodenal biopsy. CD was diagnosed in 5 patients without biopsy. NT median was higher in CD patients compared to controls (13.25 (IQR 9.4-17.5) pg/ml vs. 7.8 (IQR 7.6-10) pg/ml; p = 0.02). No statistically significant association between NT and clinical, serological, or histological data of CD was observed in this CD cohort. Conclusions To our knowledge, this is the first study that evaluates NT in CD children from Italy. Results show that NT is higher in the serum of CD children at diagnosis compared to controls. However, larger-scale studies are required to validate these findings. Whether serum NT levels can be an adjunctive marker for pediatric CD remains currently elusive.

Highlights

  • Neurotensin (NT) is a 13-amino acid peptide first isolated in 1973 from the bovine hypothalamus and digestive tract [1]

  • NT median was higher in celiac disease (CD) patients compared to controls (13.25 (IQR 9.4-17.5) pg/ml vs. 7.8 (IQR 7.6-10) pg/ml; p = 0:02) (Figure 1)

  • We found that children with untreated CD had increased fasting serum NT levels compared to controls

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Summary

Introduction

Neurotensin (NT) is a 13-amino acid peptide first isolated in 1973 from the bovine hypothalamus and digestive tract [1]. It affects sensory and motor functions, temperature regulation, neuroendocrine control of the pituitary, and control of blood flow and pressure [2] In the gut, it is secreted by endocrine N cells scattered predominantly in the epithelial layer of the jejuno-ileum and released after a meal, those containing high lipid levels [3]. The aim of this study was to evaluate serum NT levels in children with CD at diagnosis, compared to a control group, and to investigate whether NT correlated in CD patients with symptoms, antibody response, and intestinal mucosal damage. Children (1-16 years old) undergoing gastrointestinal endoscopy for CD or for other clinical reasons were included in this study. Results show that NT is higher in the serum of CD children at diagnosis compared to controls. Whether serum NT levels can be an adjunctive marker for pediatric CD remains currently elusive

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