eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2026-09-30 19 3 2292 2299 10.13005/bpj/3493 73407 article Eman Refaat Youness 1 Moushira 2 Dina Nagi 9 Marwa Ali Mahmoud 1 Rehab Selim Moustafa 1 Mohamed Gamal 3 Medical Biochemistry Department, Medical Research Institute, National Research Centre, Cairo, Egypt Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. Department of Pediatrics, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt. Department of Pediatrics, El Galaa Teaching Hospital,, General Organization of Teaching Hospitals and Institutes, Cairo, Egypt. Department of Pediatric gastroenterology, National Hepatology and Tropical Research Institute, Cairo, Egypt. Celiac disease is a gluten-triggered chronic autoimmune disorder occurring in genetically susceptible individuals. Several inflammatory cytokines, including tumor necrosis factor (TNF-α), showed elevated levels, contributing to CD pathogenesis and its aggravation. Heat shock protein -70 (HSP-70)  is  stress-induced chaperones that protect cells against injurious extracellular factors and have emerged as drug targets for autoimmune syndromes. We aimed to examine the role of TNF-α and HSPs in the pathophysiology of CD. Thirty-five children with celiac disease (22 females and 13 males) and 40 healthy controls matching age and sex were included in this case-control study. Using commercially available kits, serum anti-tissue transglutaminase antibodies, TNF-α, and HSP-70 were measured by ELISA, and HPLC measured total IgA.  The mean patients’ age at diagnosis was (5 ± 3.11) years. They mainly presented with gastrointestinal symptoms. The mean serum levels of TNF-α (157.36±18.87 pg/ml) and Heat shock protein—70 (113.34±18.77 ng/ml) were significantly increased (p= 0.001) in children with celiac disease compared to healthy controls (101.11±15.39, 62.79± 21.31) respectively. A significant positive correlation between TNF-α, HSP-70, and anti-tissue transglutaminase antibodies was delineated in children with celiac disease. Skin manifestations were present in 34.3% of CD patients. Despite the relatively small sample size, this study elucidates the association of elevated TNF-alpha and HSP-70 with celiac disease in children.  Additionally, the present results elucidated the association between CD and skin manifestations. https://biomedpharmajournal.org/vol19no3/association-of-serum-tnf-%ce%b1-and-hsp-70-with-serologic-and-cutaneous-manifestations-in-pediatric-celiac-disease/ Anti-tissue transglutaminase antibodies Celiac disease Heat shock protein- 70 Immunoglobulin A Tumor necrosis factor- α