GUT DYSBIOSIS AND EARLY CELIAC DISEASE DETECTION IN ASYMPTOMATIC CHILDREN

Abstract

Celiac disease is an immune-mediated enteropathy that frequently presents during childhood, often without overt clinical symptoms. This study aimed to investigate the role of gut dysbiosis in the early detection of celiac disease among asymptomatic children with genetic susceptibility. A total of 120 children aged 3–12 years were stratified into three groups: healthy controls, at-risk HLA-DQ2/DQ8-positive children without serological markers, and asymptomatic seropositive children. Comprehensive microbial profiling using 16S rRNA gene sequencing revealed a significant reduction in microbial diversity in seropositive children, evidenced by lower Shannon and Simpson indices and reduced Chao1 richness. Parallel to these findings, elevated levels of tissue transglutaminase antibodies (tTG-IgA), deamidated gliadin peptide antibodies (DGP-IgG), and zonulin indicated heightened immune activity and compromised intestinal barrier function. Noteworthy, seropositives demonstrated a lessening of helpful genera, for example, Bifidobacterium and Lactobacillus whereas, pro – inflammatory taxa such as Enterococcus and Prevotella were increased. These microbial changes highly correlated with serological markers and thus implied a mechanistic connection between dysbiosis and early disease pathogenesis. Heatmap and stacked bar plot analyses showed further clear shift of the microbial composition in study groups. In addition, positive relationship between tTG-IgA and zonulin levels established gut permeability-immunity association. The findings are a support for the hypothesis that gut microbiota changes precedes or coincides with early immunological disarrays in celiac disease. This demonstrates the potential of gut microbial signatures as non-invasive biomarkers for early screening in the at-risk pediatric segments. In general, the study highlights the crucial role played by gut microbiota in the early immunopathogenesis of celiac disease and sets the stage for the microbiome informed prevention strategies.