Intraepithelial lymphocyte immunophenotype: a useful tool in the diagnosis of celiac disease
- PDF / 611,237 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 53 Downloads / 144 Views
ORIGINAL ARTICLE
Intraepithelial lymphocyte immunophenotype: a useful tool in the diagnosis of celiac disease Rebeca Saborido 1 & Nazareth Martinón 1 & Alexandra Regueiro 1 & Vanesa Crujeiras 1 & Pablo Eiras 2 & Rosaura Leis 1
Received: 27 January 2017 / Accepted: 24 July 2017 # University of Navarra 2017
Abstract According to new ESPGHAN guidelines, gluten challenge is considered necessary when there is doubt about the initial diagnosis of celiac disease (CD). The main aim of this study was to quantify intraepithelial lymphocyte (IEL) immunophenotype on celiac patients on gluten-containing diet (GCD) compared to those on gluten-free diet (GFD). Another aim was to evaluate the clinical utility of IELs in the CD diagnosis, especially in selected patients on GFD where diagnostic uncertainty remains. IEL immunophenotype (TCRγδ and NK-like IELs) were studied by flow cytometry in 111 children with CD (81 children with CD on GCD and 30 celiac patients on GFD) and a control group (10 children). Duration of GFD was 5.4 ± 1.6 years. TCRγδ IELs in celiac patients receiving a GCD or GFD were significantly higher (p < 0.001) than in the control group. NK-like IELs in patients receiving a GCD or GFD were significantly lower than in the control group (p < 0.001). We observed a permanent decrease of NK-like IELs and an increment of TCRγδ IELs after following an adequate establishment and compliance of a longterm GFD in celiac patients. Recognition of IELs changes in the intestinal mucosa on celiac patients after long-term
This article forms part of a special issue of the Journal of Physiology and Biochemistry entitled BImpact of lifestyles patterns on human health: Integrated approach from the child to the elderly^ * Rebeca Saborido [email protected]
1
Paediatric Gastroenterology, Hepatology and Nutrition Unit, Department of Paediatrics, University Clinical Hospital of Santiago de Compostela, Travesa da Choupana, s/n CP 15706, Santiago de Compostela, A Coruña, Spain
2
Immunological Laboratory, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
establishment of a GFD could constitute a useful tool for CD diagnosis in various situations: in which there is doubt about the initial diagnosis and repeat biopsy is necessary (avoiding the need of gluten challenges), and in those patients with symptoms/signs suggestive of CD who maintain a low gluten diet. Keywords Flow cytometry . Mucosal immunology . Pediatric gastroenterology
Introduction According to new diagnostic criteria for celiac disease (CD) published by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), patients with mild histological lesions will need additional studies to be ruled out in order to establish the diagnosis of CD. High TCRγδ IELs count is one of these additional studies [1]. Intraepithelial lymphocytes (IELs) constitute a part of the intestinal defensive barrier and they are located surrounding epithelial cells at a ratio of 1–2:10, in healthy populations [2]. The IEL count
Data Loading...
