Alterations in intestinal microbiota of children with celiac disease at the time of diagnosis and on a gluten-free diet

Konstantina Zafeiropoulou, Ben Nichols, Mary Mackinder, Olga Biskou, Eleni Rizou, Antonia Karanikolou, Clare Clark, Elaine Buchanan, Tracey Cardigan, Hazel Duncan, David Wands, Julie Russell, Richard Hansen, Richard K. Russell, Paraic McGrogan, Christine A. Edwards, Umer Z. Ijaz, Konstantinos Gerasimidis

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)
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Background And Aims: It is not clear whether alterations in the intestinal microbiota of children with celiac disease (CD) cause the disease or are a result of disease and/or its treatment with a gluten-free diet (GFD). 

Methods: We obtained 167 fecal samples from 141 children (20 with new-onset CD, 45 treated with a GFD, 57 healthy children, and 19 unaffected siblings of children with CD) in Glasgow, Scotland. Samples were analyzed by 16S ribosomal RNA sequencing, and diet-related metabolites were measured by gas chromatography. We obtained fecal samples from 13 children with new-onset CD after 6 and 12 months on a GFD. Relationships between microbiota with diet composition, gastrointestinal function, and biomarkers of GFD compliance were explored. 

Results: Microbiota α diversity did not differ among groups. Microbial dysbiosis was not observed in children with new-onset CD. In contrast, 2.8% (Bray-Curtis dissimilarity index, P =.025) and 2.5% (UniFrac distances, P =.027) of the variation in microbiota composition could be explained by the GFD. Between 3% and 5% of all taxa differed among all group comparisons. Eleven distinctive operational taxonomic units composed a microbe signature specific to CD with high diagnostic probability. Most operational taxonomic units that differed between patients on a GFD with new-onset CD vs healthy children were associated with nutrient and food group intake (from 75% to 94%) and with biomarkers of gluten ingestion. Fecal levels of butyrate and ammonia decreased during the GFD. 

Conclusions: Although several alterations in the intestinal microbiota of children with established CD appear to be effects of a GFD, specific bacteria were found to be distinct biomarkers of CD. Studies are needed to determine whether these bacteria contribute to pathogenesis of CD.

Original languageEnglish
Pages (from-to)2039-2051.e20
Number of pages33
Issue number6
Early online date10 Aug 2020
Publication statusPublished - Dec 2020


  • Microbiome
  • OTU
  • Pediatric
  • Short-chain Fatty Acids

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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