BACKGROUND: The aim of this work was to study whether different degrees of duodenal mucosal damage in coeliac disease (CD) influenced secretory responses to well-known secretagogues. METHODS: Intestinal biopsies from 53 patients in different clinical phases of CD and 34 patients without CD and with normal histology were studied in a modified Ussing chamber. The electrogenic responses-with and without pretreatment with indomethacin-to prostaglandin E2, aminophylline, dibutyryl-cAMP and acetylcholine were followed by continuous measurements of potential difference (Pd). Tissue resistance and epithelial current (Im) were calculated. RESULTS: All secretagogues induced a similar pattern, with a greater increase in Pd and Im in biopsies with villous atrophy compared to controls. The electrophysiological response was correlated to the serum levels of IgA gliadin antibodies. The most prominent electrophysiological increase was found in the biopsies with partial atrophy. Indomethacin had a greater impact on the response to secretagogues in the more severely damaged mucosa. CONCLUSION: The electrogenic secretory response in the proximal small intestine was enhanced and related to serum levels of IgA gliadin antibodies and to the degree of mucosal damage in biopsies from children with active CD compared to controls.
BACKGROUND: The aim of this work was to study whether different degrees of duodenal mucosal damage in coeliac disease (CD) influenced secretory responses to well-known secretagogues. METHODS: Intestinal biopsies from 53 patients in different clinical phases of CD and 34 patients without CD and with normal histology were studied in a modified Ussing chamber. The electrogenic responses-with and without pretreatment with indomethacin-to prostaglandin E2, aminophylline, dibutyryl-cAMP and acetylcholine were followed by continuous measurements of potential difference (Pd). Tissue resistance and epithelial current (Im) were calculated. RESULTS: All secretagogues induced a similar pattern, with a greater increase in Pd and Im in biopsies with villous atrophy compared to controls. The electrophysiological response was correlated to the serum levels of IgA gliadin antibodies. The most prominent electrophysiological increase was found in the biopsies with partial atrophy. Indomethacin had a greater impact on the response to secretagogues in the more severely damaged mucosa. CONCLUSION: The electrogenic secretory response in the proximal small intestine was enhanced and related to serum levels of IgA gliadin antibodies and to the degree of mucosal damage in biopsies from children with active CD compared to controls.