β2-Microglobulin Levels in Celiac Disease

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Abstract
The serum levels of .beta.2-microglobulins (.beta.2-m) were studied in 65 celiac children. Significant statistical differences (p < 0.05) were found between the values of patients on a gluten-containing diet (mean .+-. SD, 1.92 .+-. 0.64mg/L) and those on a gluten-free diet for less than (mean .+-. SD, 2.38 .+-. 0.76 mg/L) or greater than (mean .+-. SD, 1.46 .+-. 0.77 mg/L) 8 months. A significant difference was also found between the first group and the 15-subject control group, who underwent intestinal biopsy for low stature or chronic diarrhea but had normal intestinal mucosa (mean .+-. SD, 1.56 .+-. 0.42 mg/L). Serum .beta.2-m levels were above normal values (< 2 mg/L) in 10 of 26 (38.5%) celiac patients on a gluten-containing diet and in two of 15 (13.3%) subjects of the control group. The .beta.2-m values of patients on a gluten-free diet for .ltoreq. 8 months were significantly different (p < 0.001) from those of patients on a gluten-free diet for > 8 months, as well from those of the control group. No significant differences were found between patients on a gluten-free diet for > 8 months and the control group. A significant correlation between the antigliadin antibody (AGA) IgA and .beta.2-m in the patients on a gluten-free diet for > 8 months and control-group patients was found. The significant statistical difference (p < 0.05) of the mean values of .beta.2-m between patients with DR3+/DR7- and DR3+/DR7+ phenotypes (if confirmed by a wider case study) could indicate a genetic heterogeneity of celiac disease. The .beta.2-m, because of its specificity (86.7%), even if the sensitivity (38.5%) is not high, could be used with AGA to select candidates for intestinal biopsy. The increase of .beta.2-m serum levels in the first months of the gluten-free diet is probably due to active regeneration of the intestinal mucosa. As the time necessary for serum values being normal is about 8 months, this could be the gluten-free period necessary before proceeding to a second biopsy.