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  • 标题:Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet
  • 本地全文:下载
  • 作者:Roberta Mandile ; Mariantonia Maglio ; Caterina Mosca
  • 期刊名称:Nutrients
  • 电子版ISSN:2072-6643
  • 出版年度:2022
  • 卷号:14
  • 期号:18
  • DOI:10.3390/nu14183696
  • 语种:English
  • 出版社:MDPI Publishing
  • 摘要:Considerable heterogeneity exists across studies assessing intestinal mucosal recovery in celiac (CD) patients on a gluten-free diet (GFD). We aimed at investigating histological and immunohistochemical features in CD patients on a long-term GFD and to correlate them to the GFD duration. Morphometrical and immunohistochemical analysis were retrospectively performed on duodenal biopsies in three groups of children: 33 on a long-term (>2 years) GFD (GFD-group), four of which remained seropositive despite dietary adherence, 31 with villous atrophy (ACD-group) and 76 heathy, non-celiac (CTR-group). Moreover, in the GFD-group, we correlated immunohistochemical alterations to the GFD duration. The villous to crypt (V/C) ratio significantly improved after the GFD and completely normalized in all patients, becoming even higher than in the CTR-group (median value 3.2 vs. 3, p = 0.007). In parallel, the number of CD3+ and TCRγδ+ cells in the epithelium were significantly reduced in the GFD compared to ACD patients, even if they remained higher than in the CTR-group ( p < 0.05). In contrast, CD25+ cells in the lamina propria significantly decreased after the GFD ( p < 0.05) and become comparable to the CTR-group ( p = 0.9). In the GFD-group there was no difference in the immunohistochemical parameters between seropositive and seronegative patients and alterations did not correlate to GFD length. In conclusion, a GFD is able to both restore a normal V/C ratio and reduce inflammation, but the epithelium maintains some stigmata of the disorder, such as an increased number of CD3+ and TCRγδ+ cells. These alterations persist regardless of the duration of the GFD.
  • 关键词:enmucosal healinggluten-free dietimmunohistochemistryvillous architecture
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