Zonulin a promising biomarker for preclinical coeliac disease screening

Zonulin levels appear to substantially increase in the months leading up to a diagnosis of coeliac disease, as reported in a study. Additionally, exposure to a greater number of antibiotic courses contribute to an increase in zonulin levels in individuals with coeliac disease, highlighting a potential role for the marker in preclinical screening.

For the study, researchers looked at 102 children who participated in the Celiac Disease Microbiome and Metabolomic Study and consumed gluten. Of the children, 51 had coeliac disease and 51 were included as matched controls.

Serum zonulin was measured from age 12 months to time of coeliac disease onset and the corresponding time point in controls. A mixed-effects longitudinal model was used in the analysis.

Compared with those in the control group, children with coeliac disease had significantly elevated zonulin in the 18.3 months (range, 6–78) preceding the diagnosis (slope differential: β, 0.1277, 95 percent confidence interval, 0.001–0.255).

Increasing number of antibiotic courses was the sole factor, among others considered, that influenced zonulin trajectory. Exposure to a greater number of antibiotic courses increased the slope of trajectory of zonulin over time in children with coeliac disease (p=0.04).

The present data suggest that zonulin has the potential to be used as a biomarker for preclinical coeliac disease screening in at-risk children, according to the researchers.