Roles of IL-21 and IL-10 in Celiac Disease Pathogenesis: Case Control Study
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Abstract
Celiac disease (CD) is an immune-mediated enteropathy induced by the ingestion of gluten in genetically predisposed subjects. Although interleukin-21 (IL-21) and interleukin-10 (IL-10) are CD4⁺ T cell-derived cytokines with reciprocal immunological functions, their distinct roles in the pathogenesis of CD remain unclear. This study aimed to measure serum IL-21 and IL-10 levels in patients with celiac disease compared with healthy controls and to analyze their correlation with disease activity. To address this aim, we conducted a case-control study involving 60 biopsy-verified patients with celiac disease and 60 age- and sex-matched healthy controls. We used ELISA to measure IL-21 and IL-10 in the blood. While also recording the levels of anti-tTG antibodies and the Marsh histopathology grades. Our findings revealed that IL-21 and IL-10 levels were significantly higher in CD patients than in controls (IL-21: 31.7 vs. 18.6 pg/mL; IL-10: 14.5 vs. 10.8 pg/mL; p < 0.001 for both). In addition, in patients with CD, IL-21 exhibited a robust positive correlation with anti-tTG titers (ρ = 0.56, p < 0.001) and Marsh grade (ρ = 0.42, p = 0.002), while IL-10 showed no significant associations (all p > 0.05). These findings indicate that although CD is associated with elevated levels of both IL-21 and IL-10, only IL-21 is strongly associated with serological and histopathological markers of active disease. Therefore, these results suggest that an inadequate compensatory anti-inflammatory response is reflected in elevated IL-10 levels, supporting IL-21 as a potential biomarker and therapeutic target in CD.
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