The Orexigenic Peptides in Children with Celiac Disease

Celiac disease is defined as a permanent gluten intolerance, which if untreated leads to malnutrition. The effect of that disease on the gut-brain axis remains unknown. This paper reports the level of plasma ghrelin, orexin A and B in a group of fifteen 8.6 ± 3.4-year-old children with untreated celiac disease and experimentally maintained on a gluten-free diet. A group of 15 age-matched healthy children served as control. Ghrelin and orexins were determined by EIA. The initial mean plasma concentration of ghrelin in the group with acute celiac disease (748.3 ± 41.1 pg/ml) was lower than that after 6 months of a gluten-free diet (812.4 ± 23.6 pg/ml; p<0. 05), but the values did not differ statistically from the values found in the control group (798.0 ± 102.5 pg/ml). The mean plasma levels of orexin A and B in children with untreated celiac disease (A: 0.99 ± 0.12 ng/ml, B: 0.59 ± 0.09 ng/ml) resembled those of healthy children (A: 0.89 ± 0.16 ng/ml; B: 0.58 ± 0.11 ng/ml). Within few months of treatment with a gluten-free diet, plasma levels of both orexins significantly increased over the levels before treatment (A: 1.19 ± 0.12 ng/ml, p < 0.001; B: 0.71 ± 0.06 ng/ml, p<0.002). Thus, a short period of gluten-free diet normalized synthesis of ghrelin in the gut. Plasma levels of orexins in the celiac children depended on the degree of malnutrition and condition of the gut mucosa.