Observations of the time-course of the inflammatory response of rectal mucosa to gliadin challenge in gluten-sensitive subjects.

Expression of endothelial adhesion molecules is a key factor in localizing inflammatory processes. We have evaluated the time-course expression of E-selectin, ICAM-1, and VCAM-1 in rectal mucosae from coeliac patients (CD) with T-lymphocyte sensitization to wheat (gliadin) protein. Ten treated, eight untreated CD patients and five disease controls underwent a dynamic 4 h rectal gluten challenge. Seven treated CD patients had a 24 h challenge to evaluate the time-course changes. Coeliac tissue significantly increased VCAM-1 expression [p < 0.001 (untreated and treated CD)] and E-selectin [p = 0.01 (untreated CD only)]-expression compared to controls but not ICAM-1. VCAM-1 continued to increase up to 24 h, while E-selectin decreased after 4 h. These findings relate to a 8 h rise in CD3 (+) lymphocytes [p < 0.05 (treated)] and a 4 h rise in neutrophils (p < 0.005). This approach permits a novel study of the inflammatory response to a known immunogen in human patients.