Shorter telomere length is associated with a more recent diagnosis of coeliac disease

Background: Coeliac disease (CD) is an autoimmune disease that causes an inappropriate inflammatory immune response to dietary gluten. Telomere length is a marker of biological ageing and is reduced in several autoimmune conditions. This observational study measured salivary telomere length (TL) in gluten-free diet (GFD) treated CD individuals to determine if CD, and length of time on a GFD, is associated with salivary TL. Methods: Clinical and demographic information was collected from CD individuals currently treated with a GFD and healthy non-affected controls. Only participants aged under 35 years at recruitment were included. Relative telomere length was measured using quantitative PCR in oral mucosa collected from saliva. Linear regression was used to determine whether salivary TL was associated with CD, or length of time on a GFD, adjusting for age and sex. Results: This study included 79 participants, 52 GFD-treated CD and 27 non-affected controls. No significant difference in salivary TL between individuals with treated CD and controls was found. Within CD individuals, salivary TL was associated with length of time on a GFD, with individuals who started a GFD ≤3 years ago having shorter salivary TL compared to those who started a GFD u003e 3 years ago (0.37±0.05 vs 0.50±0.04; p=0.002). Conclusion: Our findings indicate that salivary TL shorten while CD is untreated, however following treatment on a GFD, they appear to recover to those seen in unaffected controls. This highlights the importance of early diagnosis and initiation of GFD to minimise mucosal damage and telomere shortening, to enable TL to recover.