scholarly journals Intraepithelial lymphocytes, scores, mimickers and challenges in diagnosing gluten-sensitive enteropathy (celiac disease)

2017 ◽  
Vol 23 (4) ◽  
pp. 573 ◽  
Author(s):  
Consolato Sergi ◽  
Fan Shen ◽  
Gerd Bouma
Keyword(s):  
Celiac Disease ◽  
Intraepithelial Lymphocytes ◽  
Gluten Sensitive Enteropathy

scholarly journals The Broad Spectrum of Celiac Disease and Gluten Sensitive Enteropathy

2016 ◽  
Vol 89 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Oana Mocan ◽  
Dan L. Dumitrașcu
Keyword(s):  
Celiac Disease ◽  
Viral Infections ◽  
Villous Atrophy ◽  
Intraepithelial Lymphocytes ◽  
Intestinal Biopsy ◽  
Gluten Free ◽  
Serological Tests ◽  
Genetic Transmission ◽  
Intestinal Involvement ◽  
Gluten Sensitive Enteropathy

The celiac disease is an immune chronic condition with genetic transmission, caused by the intolerance to gluten. Gluten is a protein from cereals containing the following soluble proteins: gliadine, which is the most toxic, and the prolamins. The average prevalence is about 1% in USA and Europe, but high in Africa: 5.6% in West Sahara. In the pathogenesis several factors are involved: gluten as external trigger, genetic predisposition (HLA, MYO9B), viral infections, abnormal immune reaction to gluten. Severity is correlated with the number of intraepithelial lymphocytes, cryptic hyperplasia and villous atrophy, as well as with the length of intestinal involvement. The severity is assessed according to the Marsh–Oberhuber staging. Diagnostic criteria are: positive serological tests, intestinal biopsy, the reversal after gluten free diet (GFD). Beside refractory forms, new conditions have been described, like the non celiac gluten intolerance. In a time when more and more people adhere to GFD for nonscientific reasons, practitioners should be updated with the progress in celiac disease knowledge.       

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.

Diagnostic accuracy and usefulness of intraepithelial lymphocytes immunophenotyping in intestinal mucosa for the diagnosis of celiac disease

2019 ◽  
Vol 493 ◽  
pp. S376
Author(s):  
X. Gabaldó Barrios ◽  
S. Cladellas Núñez ◽  
M. Juanpere Aixalà ◽  
I. Fort Gallifa ◽  
L. Castro Reyes ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Diagnostic Accuracy ◽  
Intestinal Mucosa ◽  
Intraepithelial Lymphocytes

scholarly journals Evaluation of T-Bet immunostaining in the counting of intraepithelial lymphocytes in celiac disease

2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Amna E. Al-araji ◽  
Tuqa Z. Omran ◽  
Mohanad M. Ahmed ◽  
Nazar J. Metib
Keyword(s):  
Celiac Disease ◽  
Intraepithelial Lymphocytes ◽  
Clinicopathological Features ◽  
P Value ◽  
Formalin Fixed Paraffin ◽  
Histological Criteria ◽  
Formalin Fixed Paraffin Embedded ◽  
Potential Alternative ◽  
Almost All ◽  
Formalin Fixed

Objective: In this study, we aimed to evaluate CD3, T-bet and GATA3 staining of intraepithelial lymphocytes (IELs) in comparison to the routine H&E stains in celiac disease. Methods: a total of 50 patients, in whom celiac disease was diagnosed based on a combination of clinicopathological features, were enrolled in the study. Duodenal biopsied tissues were processed routinely into formalin fixed paraffin embedded (FFPE) blocks. Sections were prepared and stained with H&E and each of CD3, T-bet and GATA3. A number of histological criteria were measured to calculate the Marsh score. The results were analyzed using the IBM SPSS analytic software. Results: a positive correlation was found between the count of T-bet stained cells and the increase of intraepithelial lymphocytes (P-value = 0.001). In addition, low count of GATA3 stained cells was seen in almost all cases. The count of GATA3 stained cells was not affected by the increase in IELs count. Conclusions: the majority of increased IELs were stained with T-bet. Whereas in normal IELs count is less than half the IELs were stained with T-bet. This would indicate that T-bet immunostaining is a potential alternative to H&E and/or CD3 based counting of IELs.

scholarly journals The Screening of Critical Related Genes in Celiac Disease Based on Intraepithelial Lymphocytes Investigation: A Bioinformatics Analysis

2019 ◽  
Vol 8 ◽  
pp. 1407
Author(s):  
Mohammad Rostami-Nejad ◽  
Reza Vafaee ◽  
Mohammad Javad Ehsani-Ardakani ◽  
Nika Aghamohammadi ◽  
Aliasghar Keramatinia ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Differentially Expressed Genes ◽  
Bioinformatics Analysis ◽  
Intraepithelial Lymphocytes ◽  
Gene Expression Omnibus ◽  
T Cell Differentiation ◽  
Differentially Expressed ◽  
Protein Protein Interaction ◽  
Critical Nodes ◽  
Geo Database

Background: Celiac disease (CD) is an immunological intestinal disorder, which is characterized by response to gluten. In addition to the environmental factors and dysbiosis of the gut microbiota, genetic susceptibility has an important role in the pathogenesis of this multifactorial disorder. Therefore, this study aims to present the crucial involved genes in CD pathogenesis. Materials and Methods: In this bioinformatics analysis study, significant differentially expressed genes of intraepithelial lymphocytes (IELs) samples of celiac patients versus normal patients from Gene Expression Omnibus (GEO) database were screened via the protein-protein interaction (PPI) network. The critical nodes based on degree values, betweenness centrality, and fold changes were determined and enriched by ClueGO to find relative biological terms. Results: According to the network analysis, five central nodes including IL2, PIK3CA, PRDM10, AKT1, and SRC and eight significant differentially expressed genes (DEGs) were determined as the critical genes related to CD. Also, CD4+, CD25+, alpha-beta regulatory T cell differentiation are identified as prominent biological terms in the celiac disease patients. Conclusion: There is a possible biomarker panel related to CD that can be used as a therapeutic or diagnostic tool to manage the disease. [GMJ.2019;8:e1407]

The Intracellular Intensity of CD3 on Aberrant Intraepithelial Lymphocytes Is a Prognostic Factor of the Progression to Overt Lymphoma in Refractory Celiac Disease Type II (Pre-Enteropathy-Associated T Cell Lymphoma)

2020 ◽  
Vol 38 (6) ◽  
pp. 490-499 ◽  
Author(s):  
Carlota García-Hoz ◽  
Laura Crespo ◽  
Natalia Lopez ◽  
Ana De Andrés ◽  
Raquel Ríos León ◽  
...  
Keyword(s):  
Celiac Disease ◽  
T Cell ◽  
Cell Lymphoma ◽  
Intraepithelial Lymphocytes ◽  
Disease Type ◽  
T Cell Lymphoma ◽  
Control Group ◽  
Type Ii ◽  
Refractory Celiac Disease ◽  
Single Center Study

<b><i>Background:</i></b> Refractory celiac disease type II (RCD-II) is a very rare yet severe complication of celiac disease (CD) with a 50% rate of progression to Enteropathy-associated T-cell lymphoma (EATL). Timely diagnosis and treatment of RCD-II is of the essence and requires the identification of a population of frequently clonal, phenotypically aberrant intraepithelial lymphocytes (IELs). Flow Cytometry of intestinal IELs is the recommended method to identify the aberrant surface CD3-negative (sCD3<sup>–</sup>) intracytoplasmic CD3-positive (icCD3ε<sup>+</sup>) IELs, and a proportion of &#x3e;20% is diagnostic of RCD-II. There is substantial heterogeneity in the clinical course of RCD-II, and insufficient information on prognostic factors. <b><i>Aim:</i></b> To establish flow cytometric predictors of the clinical evolution of RCD-II, to help guide treatment approaches. <b><i>Patients and Methods:</i></b> Retrospective single-center study of clinical and immunological features of 6 RCD-II patients and a control group, both identified from a 2,000-patient cohort over 16 years. IEL subset frequencies and the intensity of staining for surface (s) and intracytoplasmic (ic) CD3ε+ on IEL subsets were quantified and correlated with the clinical outcome. <b><i>Results:</i></b> Unexpectedly, the frequency of aberrant sCD3<sup>–</sup> icCD3ε<sup>+</sup> cells at diagnosis did not correlate with histological or clinical affection. However, a higher intensity of icCD3ε<sup>+</sup> staining in the aberrant IELs relative to expression on normal IELs correlated with monoclonality and with worse clinical outcomes. <b><i>Conclusion:</i></b> The ratio of icCD3ε<sup>+</sup> on aberrant IELs vs. normal IELs appears to be a useful indicator of prognosis at the time of diagnosis, and may represent a novel tool in the follow-up of RCD-II patients after therapy.

Sign in / Sign up

Export Citation Format

Share Document