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. 2020 Jan;179(1):133-140.
doi: 10.1007/s00431-019-03490-w. Epub 2019 Nov 5.

Celiac disease and complement activation in response to Streptococcus pneumoniae

Anna Röckert Tjernberg  1   2 , Hanna Woksepp  3 , Kerstin Sandholm  4 , Marcus Johansson  5   6 , Charlotte Dahle  6   7 , Jonas F Ludvigsson  8   9 , Jonas Bonnedahl  6 , Per Nilsson  4   10 , Kristina Nilsson Ekdahl  4   11
Affiliations

Celiac disease and complement activation in response to Streptococcus pneumoniae

Anna Röckert Tjernberg et al. Eur J Pediatr. 2020 Jan.

Abstract

Individuals with celiac disease (CD) are at increased risk of invasive pneumococcal disease (IPD). The aim of this study was to explore whether the complement response to Streptococcus pneumoniae differed according to CD status, and could serve as an explanation for the excess risk of IPD in CD. Twenty-two children with CD and 18 controls, born 1999-2008, were included at Kalmar County Hospital, Sweden. The degree of complement activation was evaluated by comparing levels of activation products C3a and sC5b-9 in plasma incubated for 30 min with Streptococcus pneumoniae and in non-incubated plasma. Complement analyses were performed with enzyme-linked immunosorbent assay (ELISA). Pneumococcal stimulation caused a statistically significant increase in C3a as well as sC5b-9 in both children with CD and controls but there was no difference in response between the groups. After incubation, C3a increased on average 4.6 times and sC5b-9 22 times in both the CD and the control group (p = 0.497 and p = 0.724 respectively).Conclusion: Complement response to Streptococcus pneumoniae seems to be similar in children with and without CD and is thus unlikely to contribute to the increased susceptibility to invasive pneumococcal disease in CD.What is Known:• An excess risk of pneumococcal infections has been demonstrated in individuals with celiac disease.• Infectious complications can depend on hyposplenism but alternative mechanisms are sparsely examined.What is New:• Complement activation in response to Streptococcus pneumoniae was examined in children with and without celiac disease but no differences could be demonstrated.

Keywords: Coeliac; Infection; Innate immunity; MBL; Pneumococcal.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Distribution of C3a in individuals with CD and controls before and after pneumococcal stimulation. Bars representing mean and 95%CI. (−) Non-stimulated samples. (+) Stimulated samples
Fig. 2
Fig. 2
Distribution of C3 in individuals with CD and controls. Bars representing mean and 95%CI
Fig. 3
Fig. 3
Distribution of C3a/C3 ratio in individuals with CD and controls before and after pneumococcal stimulation. Bars representing mean and 95%CI. (−) Non-stimulated samples. (+) Stimulated samples
Fig. 4
Fig. 4
Distribution of sC5b-9 in individuals with CD and controls before and after pneumococcal stimulation. Bars representing mean and 95%CI. (−) Non-stimulated samples. (+) Stimulated samples
See this image and copyright information in PMC

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