Abstract

Gliadin peptides trigger an immune response in genetically susceptible individuals, leading to celiac disease (CeD), an autoimmune enteropathy. Probiotics benefit CeD patients and are often studied locally in the gut. One of the most interesting ways in which probiotics work is through influencing autophagy (ATG). However, probiotics influence ATG via a pathway that is not well understood. The goal of this study is to assess the relationships among probiotics, gastrointestinal symptoms, blood cell counts, and ATG biomarkers (atg7, atg16L1, beclin1, lc3, and atg12) in Jordanian CeD patients. A cohort of CeD subjects was randomized into two groups: (1) A probiotic group (n = 25) received capsules with Bifidobacterium spp., Lactobacillus spp., and S. thermophilus (5 × 109 CFU/g) twice daily for 8 weeks. (2) The control group (n = 13) received no probiotics. Dietary records and gastrointestinal symptom rating scale (GSRS) were reported. Peripheral blood samples and cell counts were taken before and after treatment. Blood mononuclear cells were isolated for RNA extraction to measure ATG gene expression via RT-qPCR. The intervention group showed a decrease in atg7 and atg16l1 expression levels, while the GSRS scores were significantly lower. Moreover, counts of neutrophils, eosinophils, and basophils were inversely related to probiotic treatment, whereas the monocyte counts were positively influenced. Changes in ATG biomarkers, leukocytes, and GSRS suggest systemic effects of probiotics in CeD patients. However, further research is needed to confirm the benefits.

Key words: Probiotics, Celiac diseases, Autophagy, Blood cell count, Gastrointestinal symptoms