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Gluten-free diet induces regression of T-cell activation in the rectal mucosa of patients with celiac disease.
Am J Gastroenterol. 1998 Sep; 93(9):1527-30.AJ

Abstract

OBJECTIVE

An increase in the number of intraepithelial lymphocytes (IEL) in the rectal epithelium of patients with active celiac disease has been described. No data are available about how they vary during a gluten-free diet. The aim of the study was to assess the effect of a gluten-free diet on T-cell activation in the rectal mucosa of adult patients with celiac disease.

METHODS

Frozen duodenal and rectal biopsies were available in four celiac patients (one male, three female, mean age 39 yr) both before and after 7 to 24 months on a gluten-free diet. Biopsy samples were stained using monoclonal antibodies directed against CD3, betaF1, TcRdelta1, CD25, and HLADR. Numbers of IEL were estimated by counting the peroxidase-stained cells per 100 epithelial cells. Four patients without histological abnormalities were used as control subjects.

RESULTS

In the four patients with active celiac disease but in none of the controls, CD25 was expressed by both duodenal and rectal lamina propria cells and HLADR was expressed by duodenal (4/4) and rectal (2/4) epithelial cells. In addition, two patients with active celiac disease had features of lymphocytic colitis, i.e., >20 IEL per 100 epithelial cells. After a gluten-free diet, the mean number of rectal CD3+ betaF1+ IEL decreased (9% vs 21%) and the expression of CD25 and HLADR was no longer present. These changes mirrored those found in the small intestinal biopsies.

CONCLUSION

These results suggest that in celiac disease, gluten-driven T-cell activation is not restricted to the proximal part of the intestine but is present on the whole intestinal length. Assessment of the effectiveness of a gluten-free diet through rectal biopsies warrants investigation, as it could lessen discomfort for patients and prove more cost-effective.

Authors+Show Affiliations

Service d'Hépato-gastroentérologie, Hôpital Laënnec Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9732937

Citation

Cellier, C, et al. "Gluten-free Diet Induces Regression of T-cell Activation in the Rectal Mucosa of Patients With Celiac Disease." The American Journal of Gastroenterology, vol. 93, no. 9, 1998, pp. 1527-30.
Cellier C, Cervoni JP, Patey N, et al. Gluten-free diet induces regression of T-cell activation in the rectal mucosa of patients with celiac disease. Am J Gastroenterol. 1998;93(9):1527-30.
Cellier, C., Cervoni, J. P., Patey, N., Leborgne, M., Marteau, P., Landi, B., Cerf-Bensussan, N., Barbier, J. P., & Brousse, N. (1998). Gluten-free diet induces regression of T-cell activation in the rectal mucosa of patients with celiac disease. The American Journal of Gastroenterology, 93(9), 1527-30.
Cellier C, et al. Gluten-free Diet Induces Regression of T-cell Activation in the Rectal Mucosa of Patients With Celiac Disease. Am J Gastroenterol. 1998;93(9):1527-30. PubMed PMID: 9732937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gluten-free diet induces regression of T-cell activation in the rectal mucosa of patients with celiac disease. AU - Cellier,C, AU - Cervoni,J P, AU - Patey,N, AU - Leborgne,M, AU - Marteau,P, AU - Landi,B, AU - Cerf-Bensussan,N, AU - Barbier,J P, AU - Brousse,N, PY - 1998/9/11/pubmed PY - 1998/9/11/medline PY - 1998/9/11/entrez SP - 1527 EP - 30 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 93 IS - 9 N2 - OBJECTIVE: An increase in the number of intraepithelial lymphocytes (IEL) in the rectal epithelium of patients with active celiac disease has been described. No data are available about how they vary during a gluten-free diet. The aim of the study was to assess the effect of a gluten-free diet on T-cell activation in the rectal mucosa of adult patients with celiac disease. METHODS: Frozen duodenal and rectal biopsies were available in four celiac patients (one male, three female, mean age 39 yr) both before and after 7 to 24 months on a gluten-free diet. Biopsy samples were stained using monoclonal antibodies directed against CD3, betaF1, TcRdelta1, CD25, and HLADR. Numbers of IEL were estimated by counting the peroxidase-stained cells per 100 epithelial cells. Four patients without histological abnormalities were used as control subjects. RESULTS: In the four patients with active celiac disease but in none of the controls, CD25 was expressed by both duodenal and rectal lamina propria cells and HLADR was expressed by duodenal (4/4) and rectal (2/4) epithelial cells. In addition, two patients with active celiac disease had features of lymphocytic colitis, i.e., >20 IEL per 100 epithelial cells. After a gluten-free diet, the mean number of rectal CD3+ betaF1+ IEL decreased (9% vs 21%) and the expression of CD25 and HLADR was no longer present. These changes mirrored those found in the small intestinal biopsies. CONCLUSION: These results suggest that in celiac disease, gluten-driven T-cell activation is not restricted to the proximal part of the intestine but is present on the whole intestinal length. Assessment of the effectiveness of a gluten-free diet through rectal biopsies warrants investigation, as it could lessen discomfort for patients and prove more cost-effective. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9732937/Gluten_free_diet_induces_regression_of_T_cell_activation_in_the_rectal_mucosa_of_patients_with_celiac_disease_ L2 - https://Insights.ovid.com/pubmed?pmid=9732937 DB - PRIME DP - Unbound Medicine ER -