Defective phagocyte activity in adult coeliac disease

Objective: The aim of this study was to investigate whether a phagocyte defect exists in coeliac disease, and if so whether it is primary or secondary to malnutrition. Design: Phagocytic activity was evaluated in 14 patients with coeliac disease, 22 patients with coeliac disease on a gluten-free diet, 10 patients with other intestinal diseases (abnormal controls) and 18 healthy controls. Methods: A chemiluminescence method was used. The following combinations were examined: neutrophils of the subject with autologous serum (PA1), neutrophils of the subject with healthy control serum (PA2), and healthy control neutrophils with serum of the subject (PA3). The results were correlated with nutritional status. Results: PA1 was significantly depressed (P < 0.001) in patients with both untreated and treated coeliac disease and abnormal controls compared with healthy controls. In both untreated and treated coeliac disease patients PA1 was significantly lower (P < 0.05) than in abnormal controls. There was no significant difference between patients with untreated and treated coeliac disease. PA2 was significantly more depressed (P < 0.001) in untreated and treated coeliac disease patients and in abnormal controls with respect to healthy controls, but there was no significant difference between these three groups of patients. PA3 was significantly more depressed (P < 0.001) in patients with untreated coeliac disease, treated coeliac disease and abnormal controls with respect to healthy controls. There was no correlation between PA values and nutritional status. Conclusions: Our results suggest that there is a significant deficit in neutrophil function and in the opsonic activity in coeliac disease serum, and that malnutrition may not be the only contributer to its onset.