Research update: Cytokines and iron

Cytokines and iron in the long term management of coeliac disease

Dr Tariq Iqbal MD FRCP, City Hospital, Birmingham

Summary
The gluten intolerance of coeliac disease leads to bowel symptoms, weight loss and iron deficiency. Despite conforming to a gluten-free diet many patients remain iron deficient. This ongoing anaemia can cause troublesome symptoms such as chronic tiredness, shortness of breath and a poorer quality of life.

We believe that iron deficiency is partly mediated by specialised cells within the intestine wall. These cells are lymphocytes and secrete proteins called cytokines. These cytokines in turn are able to alter proteins responsible for absorbing iron in the intestine wall.

Consequently the patient is unable to absorb iron effectively even in the face of consuming adequate iron in the diet. It is our aim to understand this process in greater detail and identify which cytokines are most important in this process with a view to blocking this process, thus restoring the iron absorbing capacity of the intestine.

We hope this work will ultimately lead to the development of medicines which would prevent iron deficiency in coeliac treated patients and restore a normal quality of life to these individuals.