{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:39:13Z","timestamp":1791268753043,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diagnosis of celiac disease (CD) remains challenging in individuals already on a gluten-free diet (GFD). Although several alternative methods have been proposed, they have limitations. Identifying inflammation-related proteins that rapidly respond to gluten exposure in blood may offer diagnostic alternatives. We aimed to characterize the inflammatory protein response to gluten in patients with CD on a GFD, and to assess the diagnostic potential of candidate biomarkers and their association with clinical symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventeen patients with CD and 15 non-CD individuals on a GFD (\u2265 1 month) consumed 10 g of gluten. Serum, plasma and clinical symptoms were collected at baseline and 4 h post-gluten ingestion to assess changes in 92 inflammation-related proteins. CCL20 levels were also measured by ELISA in plasma from 13 patients with CD and 11 non-CD individuals from the initial cohort, and in an additional group of 28 individuals evaluated for suspected CD, three of whom received a final diagnosis of CD. In 15 patients with CD, the results were compared to those of other diagnostic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve proteins showed significantly different fold changes following gluten challenge between CD and non-CD groups. Six showed an AUC \u226580%, and CCL20 achieved 81.3-85.7% sensitivity and 88.9-92.7% specificity for CD diagnosis. CCL20 level increases post-gluten challenge were higher in patients with vomiting but were also observed in those with absent or mild symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gluten reintroduction triggers alterations in the inflammation-related protein profile of patients with CD. CCL20 emerges as a promising diagnostic candidate, its increase in plasma or serum, with low dependence on symptom presentation, may complement existing diagnostic approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1745890","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T16:33:10Z","timestamp":1768235590000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Acute gluten-induced inflammatory response highlights CCL20 as a potential biomarker for celiac 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