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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 μ/L) and CD56+ NK cells (366.24 vs. 2440.46 μ/L) were significantly lower in the celiac group than the control group (P0.05 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 were 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 had 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.

Background Various biomarkers have been investigated in the diagnosis of cow's milk protein allergy (CMPA) in infants. To our knowledge, no prior studies have evaluated serum eosinophil cationic protein (sECP), neutrophil-lymphocyte ratio (NLR), and mean platelet volume (MPV) concurrently in infants with CMPA. Objective To compare sECP levels, MPV, and NLR in infants with and without CMPA, as well as to investigate the suitability of these parameters as biomarkers in the diagnosis of CMPA. Methods Fifty-six children with CMPA were compared to 40 healthy, similar to distribution of age and sex normal infants as controls. The serum ECP levels were detected by a chemiluminescence assay. The MPV values were calculated by devices in hemogram parameters. The NLR values were obtained by dividing the neutrophil count by the lymphocyte count. Results The median sECP level in the CMPA group was significantly higher than in the control group (23.5 and 9.27 ng/mL, respectively; P=0.001). However, there were no significant differences between groups with regards to median MPV (8.5 and 8.6 fL, respectively; P=0.149) and median NLR (0.35 and 0.37 respectively; P=0.637). Correlation analysis of sECP level with MPV and NLR in the CMPA group revealed no significant relationships (P>0.05 for both). In the Receiver-operating characteristic (ROC) curve analysis, the optimal cut-off levels to identify CMPA for sECP, MPV, and NLR were 18.4 ng/mL (60.7% sensitivity, 97.5% specificity, and AUC: 0.831), 10.05 fL (54% sensitivity, 77.5% specificity, and AUC: 0.413) and 0.97 (14.3% sensitivity, 50% specificity, and AUC: 0.528), respectively. Conclusions The sECP level and blood eosinophil count are significantly higher in infants with CMPA, but MPV and NLR do not differ between infants with and without CMPA. There are also no significant correlations in the CMPA group between sECP and MPV, as well as sECP and NLR. Serum ECP might be useful as a potential biomarker for diagnosing CMPA.