Evaluating the Correlation Between Fecal Microbiota Profiles and Clinical Presentation in Pediatric Patients with Celiac Disease

Background: Celiac disease (CD) is an immune-mediated disorder triggered by gluten in genetically susceptible individuals, often presenting with diverse gastrointestinal and non-gastrointestinal symptoms. Emerging evidence suggests that alterations in gut microbiota composition may influence disease manifestation and clinical outcomes. We investigated the correlation between gut microbiota profiles and clinical features in pediatric patients with CD. Methods: 38 pediatric patients (mean age 10.24 years) with confirmed CD were enrolled from August 2021 to September 2022. We had the data on the relative abundance of various fecal microbiota from our previous study, and collected their clinical and demographic data through questionnaires. Genotyping of human leukocyte antigens (HLA)-DQ2 and HLA-DQ8 alleles was performed. Results: Significant correlations were found between gut microbiota and both gastrointestinal (GI) and non-GI symptoms. Enterobacteriaceae and Streptococcus were positively associated with diarrhea (OR: 5.23 and OR: 3.46), whereas deltaproteobacteria showed a negative correlation (OR: 0.07). Betaproteobacteria and Staphylococcus were linked to vomiting (OR: 0.05 and OR: 12.59). Firmicutes and Actinobacteria correlated with weight loss (OR: 2.73 and OR: 16.21), and Verrucomicrobia inversely correlated with fatigue (OR: 0.36). The prevalent HLA genotype DQ2 was correlated positively with Betaproteobacteria (OR: 14.82) and Prevotella (OR: 5.05), while Veillonella showed a negative correlation with HLA-DQ2 (OR: 0.43). Conclusion: Overall, the analysis revealed distinct microbiota patterns influenced by symptom presentation and HLA-DQ genotypes, underscoring the need for further research into the therapeutic potential of modifying gut microbiota in managing CD.