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      Exploring celiac disease candidate pathways by global gene expression profiling and gene network cluster analysis

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          Abstract

          Celiac disease (CeD) is a gastrointestinal autoimmune disorder, whose specific molecular basis is not yet fully interpreted. Therefore, in this study, we compared the global gene expression profile of duodenum tissues from CeD patients, both at the time of disease diagnosis and after two years of the gluten-free diet. A series of advanced systems biology approaches like differential gene expression, protein–protein interactions, gene network-cluster analysis were deployed to annotate the candidate pathways relevant to CeD pathogenesis. The duodenum tissues from CeD patients revealed the differential expression of 106 up- and 193 down-regulated genes. The pathway enrichment of differentially expressed genes (DEGs) highlights the involvement of biological pathways related to loss of cell division regulation (cell cycle, p53 signalling pathway), immune system processes (NOD-like receptor signalling pathway, Th1, and Th2 cell differentiation, IL-17 signalling pathway) and impaired metabolism and absorption (mineral and vitamin absorptions and drug metabolism) in celiac disease. The molecular dysfunctions of these 3 biological events tend to increase the number of intraepithelial lymphocytes (IELs) and villous atrophy of the duodenal mucosa promoting the development of CeD. For the first time, this study highlights the involvement of aberrant cell division, immune system, absorption, and metabolism pathways in CeD pathophysiology and presents potential novel therapeutic opportunities.

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          Most cited references43

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          Coeliac disease

          Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations. Diagnosis requires the presence of duodenal villous atrophy, and most patients have circulating antibodies against tissue transglutaminase; in children, European guidelines allow a diagnosis without a duodenal biopsy provided that strict symptomatic and serological criteria are met. Although a gluten-free diet is an effective treatment in most individuals, a substantial minority develop persistent or recurrent symptoms. Difficulties adhering to a gluten-free diet have led to the development of non-dietary therapies, several of which are undergoing trials in human beings.
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            A genome-wide association study for celiac disease identifies risk variants in the region harboring IL2 and IL21.

            We tested 310,605 SNPs for association in 778 individuals with celiac disease and 1,422 controls. Outside the HLA region, the most significant finding (rs13119723; P = 2.0 x 10(-7)) was in the KIAA1109-TENR-IL2-IL21 linkage disequilibrium block. We independently confirmed association in two further collections (strongest association at rs6822844, 24 kb 5' of IL21; meta-analysis P = 1.3 x 10(-14), odds ratio = 0.63), suggesting that genetic variation in this region predisposes to celiac disease.
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              Effect of a gluten-free diet on gastrointestinal symptoms in celiac disease.

              Atypical presentations of celiac disease appear to be at least as common as is the classic presentation of steatorrhea, diarrhea, and weight loss. We examined the effect of a gluten-free diet on gastrointestinal symptoms in a cohort of US patients with celiac disease. A follow-up survey was conducted in 215 patients who were evaluated at the University of Iowa from 1990 through 1997 as having biopsy-confirmed celiac disease. The systematic survey asked detailed questions regarding gastrointestinal symptoms before and after the institution of a gluten-free diet in the patients, all of whom had been given the same dietary advice. The group consisted of 160 female and 55 male patients. Although diarrhea was the most frequent symptom in untreated celiac disease, steatorrhea occurred in only one-fifth of patients. Other complaints were common, and most responded to gluten exclusion. The benefit of gluten exclusion was equally apparent in men and women. Diarrhea responded in most patients, usually within days, and the mean time to resolution was 4 wk. Many patients had alternating diarrhea and constipation, both of which were responsive to the gluten-free diet. Most patients had abdominal pain and bloating, which resolved with the diet. Celiac disease causes a wide range of gastrointestinal symptoms. Clinicians must have a high level of suspicion to detect the atypical forms of celiac disease. With a gluten-free diet, patients have substantial and rapid improvement of symptoms, including symptoms other than the typical ones of diarrhea, steatorrhea, and weight loss.
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                Author and article information

                Contributors
                relango@kau.edu.sa
                nshaik@kau.edu.sa
                Journal
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                1 October 2020
                1 October 2020
                2020
                : 10
                : 16290
                Affiliations
                [1 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Department of Genetic Medicine, Faculty of Medicine, , King Abdulaziz University, ; Jeddah, 21589 Saudi Arabia
                [2 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [3 ]GRID grid.460099.2, Department of Biology, College of Science, , University of Jeddah, ; Jeddah, Saudi Arabia
                [4 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Department of Biological Sciences, Faculty of Science, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [5 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [6 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Department of Health Information Technology, Faculty of Applied Studies, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                [7 ]GRID grid.412125.1, ISNI 0000 0001 0619 1117, Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, , King Abdulaziz University, ; Jeddah, Saudi Arabia
                Article
                73288
                10.1038/s41598-020-73288-6
                7529771
                33004927
                bb895de8-b284-4b14-8093-94ce98760e17
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 8 March 2020
                : 27 August 2020
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                © The Author(s) 2020

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                molecular biology,computational biology and bioinformatics
                Uncategorized
                molecular biology, computational biology and bioinformatics

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