Ana De Andrés1, Cristina Camarero, Garbiñe Roy. 1. Department of Immunology, Hospital Universitario Ramón y Cajal de Madrid, Carretera de Colmenar km 9100, 28034, Madrid, Spain, aandres.hrc@salud.madrid.org.
Abstract
BACKGROUND AND AIM: After clinical screening and the serological test, many patients still require a duodenal biopsy for celiac disease diagnosis. Mild histological lesions, unspecific findings and patchiness are frequent outcomes of this mandatory diagnostic tool, thus complicating clinical decisions. METHODS: We analyzed the lymphoid components [number of total intraepithelial lymphocytes (IELs), TcR-γδ and CD3(-)IELs] of the duodenal epithelium by flow cytometry in samples obtained from bulb and distal duodenum during upper gastrointestinal endoscopies performed for diagnostic purposes. RESULTS: IEL counts and IEL subset distribution (IEL lymphogram) remain invariant along duodenal mucosa revealing a specific profile (immunophenotype) that characterizes either a healthy mucosa or a celiac mucosa. The celiac immunophenotype persists regardless of the biopsy's anatomical location or the corresponding histological findings. CONCLUSIONS: We propose the IEL lymphogram by flow cytometry as an immunological parameter to discern celiac condition from healthy mucosa. This obviates not only misinterpretation of minor histological changes, but also patchiness and the concerns about the location and number of biopsies.
BACKGROUND AND AIM: After clinical screening and the serological test, many patients still require a duodenal biopsy for celiac disease diagnosis. Mild histological lesions, unspecific findings and patchiness are frequent outcomes of this mandatory diagnostic tool, thus complicating clinical decisions. METHODS: We analyzed the lymphoid components [number of total intraepithelial lymphocytes (IELs), TcR-γδ and CD3(-)IELs] of the duodenal epithelium by flow cytometry in samples obtained from bulb and distal duodenum during upper gastrointestinal endoscopies performed for diagnostic purposes. RESULTS: IEL counts and IEL subset distribution (IEL lymphogram) remain invariant along duodenal mucosa revealing a specific profile (immunophenotype) that characterizes either a healthy mucosa or a celiac mucosa. The celiac immunophenotype persists regardless of the biopsy's anatomical location or the corresponding histological findings. CONCLUSIONS: We propose the IEL lymphogram by flow cytometry as an immunological parameter to discern celiac condition from healthy mucosa. This obviates not only misinterpretation of minor histological changes, but also patchiness and the concerns about the location and number of biopsies.
Authors: Ivor D Hill; Martha H Dirks; Gregory S Liptak; Richard B Colletti; Alessio Fasano; Stefano Guandalini; Edward J Hoffenberg; Karoly Horvath; Joseph A Murray; Mitchell Pivor; Ernest G Seidman Journal: J Pediatr Gastroenterol Nutr Date: 2005-01 Impact factor: 2.839
Authors: Cristina Camarero; Ana De Andrés; Carlota García-Hoz; Belén Roldán; Alfonso Muriel; Francisco León; Garbiñe Roy Journal: Clin Transl Gastroenterol Date: 2021-11-10 Impact factor: 4.488
Authors: Kamran Rostami; Michael N Marsh; Matt W Johnson; Hamid Mohaghegh; Calvin Heal; Geoffrey Holmes; Arzu Ensari; David Aldulaimi; Brigitte Bancel; Gabrio Bassotti; Adrian Bateman; Gabriel Becheanu; Anna Bozzola; Antonio Carroccio; Carlo Catassi; Carolina Ciacci; Alexandra Ciobanu; Mihai Danciu; Mohammad H Derakhshan; Luca Elli; Stefano Ferrero; Michelangelo Fiorentino; Marilena Fiorino; Azita Ganji; Kamran Ghaffarzadehgan; James J Going; Sauid Ishaq; Alessandra Mandolesi; Sherly Mathews; Roxana Maxim; Chris J Mulder; Andra Neefjes-Borst; Marie Robert; Ilaria Russo; Mohammad Rostami-Nejad; Angelo Sidoni; Masoud Sotoudeh; Vincenzo Villanacci; Umberto Volta; Mohammad R Zali; Amitabh Srivastava Journal: Gut Date: 2017-09-11 Impact factor: 23.059