Alterations in the intestinal microbiota of children with established celiac disease (CD) appear to be the result of a gluten-free diet, according to study results published in Gastroenterology. However, there are specific bacteria that are distinct biomarkers of CD.

Adherence to a gluten-free diet is the only treatment for CD; however, it is not clear whether alterations in intestinal microbiota cause the disease, or if changes are a result of CD and/or its treatment with a gluten-free diet. Researchers in Scotland obtained 167 fecal samples from 141 children (20 with new-onset CD, 45 treated with a gluten-free diet, 57 healthy children, and 19 unaffected siblings of children with CD) as well as additional fecal samples from 13 of the children with new-onset CD after 6 and 12 months on a gluten-free diet.

Investigators did not find a difference in microbiota α diversity among groups. While microbial dysbiosis was not observed in children with new-onset CD, 2.8% and 2.5% (P =.025 and P =.027, respectively) of the variation in microbiota composition could be accounted for by the gluten-free diet.

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Between 3% and 5% of all taxa differed among all group comparisons, and 11 distinctive operational taxonomic units composed a microbe signature specific to CD with high diagnostic probability. Most of the operational taxonomic units that differed between patients on a gluten-free diet with new-onset CD compared with healthy children were associated with nutrient and food group intake (from 75%-94%) and with biomarkers of gluten ingestion. Fecal levels of butyrate and ammonia decreased during the gluten-free diet.

Study limitations include the modest sample size of the prospective group.

“In conclusion, we identified a set of bacteria which may comprise another important environmental factor in the pathogenesis of CD and which warrant further research, but also demonstrated that several alterations in the microbiota of patients with established CD are likely to be secondary effects of disease treatment,” the authors concluded.

Disclosure: This clinical trial was supported by the Nutricia Research Foundation. Please see the original reference for a full list of authors’ disclosures.  


Zafeiropoulou K, Nichols B, Mackinder M, et al. Alterations in intestinal microbiota of children with celiac disease at time of diagnosis and on a gluten-free diet [published online August 10, 2020]. Gastroenterology. doi: 10.1053/j.gastro.2020.08.007

This article originally appeared on Gastroenterology Advisor