Allogeneic hematopoietic stem cell transplantation may restore gluten tolerance in patients with celiac disease

J Pediatr Gastroenterol Nutr. 2013 Apr;56(4):422-7. doi: 10.1097/MPG.0b013e318276a6a7.

Abstract

We report on 2 patients affected by both celiac disease (CD) and β-thalassemia major who underwent successful myeloablative allogeneic hematopoietic stem cell transplantation (HSCT) for the latter condition. After HSCT, the introduction of a gluten-containing diet did not cause the reappearance of clinical, serological, and histological markers of CD in up to 5 years of follow-up. After transplantation, in both patients, dendritic cells and regulatory FoxP3T cells showed a recovery of normal values and no proliferative T-cell response upon gliadin stimulation was found. These data suggest that allogeneic HSCT may lead to induction of gluten tolerance in patients with CD.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Celiac Disease / complications
  • Celiac Disease / immunology
  • Celiac Disease / pathology
  • Celiac Disease / therapy*
  • Child, Preschool
  • Female
  • Glutens / adverse effects*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immune Tolerance*
  • Intestinal Mucosa / immunology*
  • Intestinal Mucosa / pathology
  • Intestines / immunology*
  • Intestines / pathology
  • Male
  • Transplantation, Homologous / immunology
  • Treatment Outcome
  • beta-Thalassemia / complications
  • beta-Thalassemia / therapy

Substances

  • Glutens