scholarly journals Intestinal TG3- and TG2-Specific Plasma Cell Responses in Dermatitis Herpetiformis Patients Undergoing a Gluten Challenge

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 467
Author(s):  
Hanna Sankari ◽  
Minna Hietikko ◽  
Kalle Kurppa ◽  
Katri Kaukinen ◽  
Eriika Mansikka ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Dermatitis Herpetiformis ◽  
Immunoglobulin A ◽  
Small Intestinal Mucosa ◽  
Gluten Free ◽  
Cell Responses ◽  
Small Intestinal ◽  
Circulating Autoantibodies

Dermatitis herpetiformis (DH), a cutaneous manifestation of coeliac disease, is characterized by transglutaminase (TG) 3-targeted dermal immunoglobulin A (IgA) deposits. The treatment for DH is the same as for coeliac disease, namely a life-long gluten-free diet. DH patients typically have gluten-dependent circulating autoantibodies targeting TG3 and TG2, and plasma cells secreting such autoantibodies have been detected in the small intestinal mucosa. This study investigates the gluten-responsiveness of intestinal TG3 and TG2 antibody-secreting plasma cells in 16 treated DH patients undergoing a gluten challenge. The frequency of both plasma cell populations increased significantly during the challenge, and their frequency correlated with the corresponding serum autoantibody levels at post-challenge. TG3-specific plasma cells were absent in all 18 untreated coeliac disease patients and seven non-coeliac control subjects on gluten-containing diets. These findings indicate that, in DH, both intestinal TG3- and TG2-antibody secreting plasma cells are gluten-dependent, and that TG3-antibody secreting plasma cells are DH-specific.

scholarly journals Missing Insight Into T and B Cell Responses in Dermatitis Herpetiformis

2021 ◽  
Vol 12 ◽  
Author(s):  
Esko Kemppainen ◽  
Teea Salmi ◽  
Katri Lindfors
Keyword(s):  
T Cells ◽  
Celiac Disease ◽  
Small Bowel ◽  
B Cell ◽  
Plasma Cells ◽  
Dermatitis Herpetiformis ◽  
Gluten Free Diet ◽  
Cell Populations ◽  
Gluten Free ◽  
Cell Responses

Dermatitis herpetiformis is a cutaneous form of celiac disease manifesting as an itching rash typically on the elbows, knees and buttocks. It is driven by the ingestion of gluten-containing cereals and characterized by granular deposits of immunoglobulin A in the papillary dermis. These antibodies target transglutaminase (TG) 3 and in the majority of patients they are also found in circulation. The circulating antibodies disappear and skin symptoms resolve as a result of gluten-free diet but the cutaneous anti-TG3 IgA deposits may persist for several years. In dermatitis herpetiformis, plasma cells secreting antibodies against TG3 are located in the intestinal mucosa similarly to those producing TG2 antibodies characteristic for celiac disease. In fact, both TG2- and TG3-specific plasma cells and gluten responsive T cells are found in dermatitis herpetiformis patients but the interplay between these cell populations is unknown. The small bowel mucosal damage in celiac disease is believed to be mediated by co-operation of cytotoxic intraepithelial T cells and the inflammatory milieu contributed by gluten-reactive CD4+ T cells, whereas the skin lesions in dermatitis herpetiformis appear to be devoid of gluten reactive T cells. Thus, how celiac disease-type intestinal T and B cell responses develop into an autoimmune condition affecting the skin is still incompletely understood. Finally, the skin and small bowel lesions may reappear upon reintroduction of gluten in patients treated with gluten-free diet but virtually nothing is known about the long-lived B cell and memory T cell populations activating in response to dietary gluten in dermatitis herpetiformis.

scholarly journals The Challenge of Treatment in Potential Celiac Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Chiara Maria Trovato ◽  
Monica Montuori ◽  
Francesco Valitutti ◽  
Beatrice Leter ◽  
Salvatore Cucchiara ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Immunoglobulin A ◽  
Intraepithelial Lymphocytes ◽  
Gluten Free Diet ◽  
Small Intestinal Mucosa ◽  
Gluten Free ◽  
Main Challenge ◽  
Genetic Features ◽  
Diagnostic Work ◽  
Work Up

Potential celiac disease (PCD) is defined by the presence of positive serum antibodies, HLA-DQ2/DQ8 haplotypes, and a normal small intestinal mucosa (Marsh grade 0-1). This condition occurs in one-fifth of celiac disease (CD) patients and usually represents a clinical challenge. We reviewed genetic, histologic, and clinical features of this specific condition by performing a systematic search on MEDLINE, Embase, and Scholar database. Accordingly, we identified different genetic features in patients with PCD compared to the classical forms. Frequently, signs of inflammation (deposits of immunoglobulin A (IgA) and/or increased number of intraepithelial lymphocytes) can be clearly identify in the mucosa of PCD patients after an accurate histological assessment. Finally, the main challenge is represented by the treatment: the gluten-free diet should be considered only in the presence of gluten-dependent symptoms in both children and adults. What is known: (i) potential celiac disease (PCD) occurs in one-fifth of all celiac diseases (CD), and (ii) despite the absence of classical lesions, clear signs of inflammation are often detectable. What is new: (i) patients with PCD show different genetic features, and (ii) the presence of gluten-dependent symptoms is the main determinant to initiate the gluten-free diet, after a complete diagnostic work-up.

scholarly journals The Small Intestinal Mucosa in Dermatitis Herpetiformis

1971 ◽  
Vol 60 (3) ◽  
pp. 355-361 ◽  
Author(s):  
J.R. Brow ◽  
F. Parker ◽  
W.M. Weinstein ◽  
C.E. Rubin
Keyword(s):  
Intestinal Mucosa ◽  
Dermatitis Herpetiformis ◽  
Small Intestinal Mucosa ◽  
Small Intestinal
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