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Asri N, Ahmadi B, Taraghikhah N, Houri H, Jahani-Sherafat S, Rezaei-Tavirani M, et al . Tryptophan and Sleep Disruptions in Patients With Celiac Disease. BCN 2025; 16 (3) :677-690
URL: http://bcn.iums.ac.ir/article-1-2997-fa.html

Introduction: Inflammatory responses in celiac disease (CD) may lead to immune dysregulation and sleep disturbance. Additionally, impaired tryptophan (Trp) metabolism in the gastrointestinal tract has been linked to chronic intestinal inflammation. This study aimed to investigate the relationship between sleep disorders, Trp levels, and cytokine profiles in patients with CD. 
Methods: A cohort study involving 76 adults with CD (mean age 40.3 years) was conducted from March to December 2022. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) questionnaire. Plasma Trp levels were measured using high-performance liquid chromatography (HPLC), and serum tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-10 levels were determined using enzyme-linked immunosorbent assay (ELISA). IL-2 and IL-4 expression was evaluated using quantitative real-time polymerase chain reaction (qPCR).
Results: A significant proportion (63.2%) of patients with CD experienced poor sleep quality. Additionally, increasing age was positively correlated with sleep disturbances. Importantly, patients with CD and poor sleep quality had lower plasma Trp levels than those with good sleep quality (P<0.0001). Moreover, individuals with poor sleep quality exhibited elevated IL-2 levels (P=0.03) compared to those with good sleep quality. Conversely, no significant difference was observed in IL-4, IL-10, and TNF-α levels between individuals with poor and good sleep quality. 
Conclusion: Low Trp levels may indicate the potential for Trp supplementation to alleviate sleep disturbances in patients with CD. However, further research is required to understand the underlying mechanisms and evaluate potential interventions.