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Indian J Pathol Microbiol. 2019 Jul-Sep;62(3):399-404. doi: 10.4103/IJPM.IJPM_703_18.

Duodenal mucosal immune cells in treatment-naive adult patients with celiac disease having different histological grades and controls.

Author information

1
Department of Pathology, AIIMS, New Delhi, India.
2
Department of Gastroenterology and Human Nutritions, AIIMS, New Delhi, India.
3
Department of Biostatistics, AIIMS, New Delhi, India.

Abstract

Background:

It is hypothesized that the duodenal mucosal damage in patients with celiac disease (CeD) is caused by the mucosa-infiltrating lymphoid cells. This study aimed to analyze the immune effective and regulatory T (Treg) cells in duodenal biopsies from treatment-naive adult patients with CeD having different histological grades and controls.

Patients and Methods:

Dual-color immunohistochemical staining was done in a total of 234 duodenal biopsies, including 132 controls and 102 adult patients with CeD using CD20, CD3:CD4, CD3:CD8, CD4:FoxP3, CD8:FoxP3, and TCRαβ:TCRγδ antibodies. The density of these lymphoid cells in lamina propria and mucosal epithelium was compared between controls and CeD, with different modified Marsh grades.

Results:

Densities of CD4+ T cells in lamina propria and CD8+γδ intraepithelial lymphocytes (IELs) were significantly more in biopsies from patients with CeD, than in controls. An increasing linear pattern of IELs, CD3+ T cells, and CD20+ B cells was observed with increasing grades of villous abnormalities. Although CD8+ FoxP3+ Treg cells were significantly more in biopsies from patients with CeD, there was no significant difference in CD4+ FoxP3+ Treg cell infiltrate between both the groups.

Conclusion:

Our finding in this observational study generates interest to study the local intestinal mucosal immunity in CeD in detail. A study to prove the failure of CD4+ FoxP3+ Treg cell recruitment in CeD and its direct functional impact may yield valuable information regarding loss of mucosal tolerance.

KEYWORDS:

Duodenum; immunohistochemistry; intraepithelial lymphocytes; mucosa; tolerance

PMID:
31361227
DOI:
10.4103/IJPM.IJPM_703_18
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