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-en.html
1- Student Research Committee, Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6- Department of Health and Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract:
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.
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● Among patients with CD, 63.2% reported poor sleep quality, which was linked to age.
● Poor sleep in patients with CD correlates with lower plasma Trp levels.
● Increased IL-2 levels were observed in individuals with poor sleep; no changes were observed in other cytokines.
Plain Language Summary
Celiac disease (CD) is a chronic autoimmune disorder that causes the immune system to react negatively to gluten, a protein found in wheat, barley, and rye. Many individuals with CD experience a range of symptoms, including gastrointestinal issues, fatigue, and mood disorders. This study aimed to explore the impact of CD on sleep quality and investigate the role of tryptophan (Trp), a crucial amino acid involved in sleep regulation and immune function. Conducted from March to December 2022, the study included 76 adults with CD, with an average age of 40 years. We used a sleep quality questionnaire and measured Trp levels and certain immune markers in participants’ blood. We found that 63.2% of participants reported poor sleep quality. Older age was associated with worse sleep, and individuals with poor sleep had significantly lower levels of Trp in their plasma compared to those with good sleep. Conversely, individuals with poor sleep exhibited higher levels of interleukin-2 (IL-2), which is involved in inflammation. These results suggest that low Trp levels may contribute to sleep problems in patients with CD, pointing to the potential benefits of Trp supplementation as a treatment to improve sleep quality. However, future research is required to fully understand how these factors interact and to explore effective treatment options. This study highlights the importance of regularly assessing sleep in patients with CD to improve their overall health and well-being.
Type of Study:
Original |
Subject:
Behavioral Neuroscience Received: 2024/08/10 | Accepted: 2024/09/14 | Published: 2025/05/1