Potential celiac disease (CeD) patients have positive CeD associated antibodies (anti-tissue tansglutaminase antibodies) and HLA-DQ2 and/or HLA-DQ8 genotype but no intestinal inflammation. NMR based metabonomic study of blood plasma of potential CeD patients demonstrated a distinct metabolic fingerprint characterized by raised histidine and proline in comparison to healthy controls. The changes in histidine suggested compromised cytoprotective mechanism while elevated arginine level indicated altered functioning of intestinal cells in potential CeD. These altered metabolic activities could be the initial event that precede the pathogenesis of CeD and may contribute to intestinal inflammation which results in villous atrophy.
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