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Evaluation of microvilli in gluten-sensitive enteropathy by means of scanning and transmission electron microscopy.

Biopsies from jejunum of nonceliac patients and patients with active celiac disease were studied and compared by means of transmission (TEM) and scanning (SEM) electron microscopy. Fracturing of dried specimens enabled the visualization of the epithelial microvilli with SEM. Alteration in microvillous appearance in celiac patients, as determined by TEM, could also be clearly detected in SEM images. The SEM preparation is easier to accomplish and less time-consuming compared to the TEM. This may be an advantage for clinical assessment of jejunal biopsies in syndromes in which early detection of alterations in microvilli in the epithelial mucosa is of diagnostic value.

Biopsy↗

Experimentally induced gluten enteropathy and protective effect of epidermal growth factor in artificially fed neonatal rats.

BACKGROUND: A protective effect of breast-feeding against the development of celiac disease has been described, but the nature and effects of the actual milk components have not been established. Epidermal growth factor (EGF), a milk cytokine affecting the proliferation and differentiation of mucosal epithelial cells, was studied as to its potential protective effect on the damage of intestinal mucosa by gliadin in a model system. METHODS: Enteropathy was induced by gliadin in inbred AVN strain rat pups delivered by cesarean section, breast-fed, or hand-fed a milk formula. All experimental groups were treated with interferon-gamma (1,000 U per animal, administered intraperitoneally) after birth. Gliadin (0.5 and 3 mg) was intragastrically administered to the pups on days 0 and 3, and a 30-mg challenge dose was given on day 20 (24 hours before the termination of the experiment). One group of artificially fed pups received EGF (100 ng/ml) continuously in the diet. RESULTS: Gliadin- and interferon-gamma-treated formula-fed rat pups showed villus atrophy, increase of inflammatory cells, including CD4+ T lymphocytes in the lamina propria, and damage to epithelial tight junctions and the enterocyte brush border. Morphometrically, the villus height was significantly less than in other groups. Recombinant EGF was markedly increased in the epithelial cells of injured jejunum. The intestinal mucosa of gliadin- and interferon-gamma-treated pups kept on a EGF-supplemented artificial diet resembled that of breast-fed pups. CONCLUSION: Pathologic changes in jejunal mucosa (villus atrophy and inflammation) resembling gliadin-induced atrophy appeared on administration of interferon-gamma and gliadin to rat pups fed an artificial milk diet immediately after birth. Addition of EGF to the diet protected the rats against pathologic mucosal changes.

Animals↗

Endomysial antibody production is not related to histological damage after in vitro gluten challenge.

OBJECTIVE: To determine whether in vitro induction of endomysial antibodies is an in vitro marker of coeliac toxicity. DESIGN: To determine whether in vitro endomysial antibodies induced by gliadin incubation correlate with histological damage induced by in vitro gliadin challenge. METHODS: Small-bowel organ cultures from seven patients with treated coeliac disease were incubated in an organ culture system with gliadin; histological damage was morphometrically evaluated and endomysial antibodies were measured in the organ culture supernatant by indirect immunofluorescence. RESULTS: Although incubation with gliadin caused histological damage, there was no detectable production of endomysial antibody. CONCLUSIONS: In vitro, endomysial antibody induction cannot be used as a marker of coeliac toxicity. Endomysial antibodies are not necessary for generating the histological lesion of coeliac disease.

Adult↗

Is there a connection between severe cerebral palsy and increased gluten sensitivity?

UNLABELLED: In nine children with severe cerebral palsy (CP), feeding difficulties and poor development of weight and height, laboratory markers for metabolic and enteral dysfunction were studied. CONCLUSION: Four of the nine patients with CP had increased levels of antigliadin antibodies AGA (IgA), a finding which calls for further studies concerning the possible connection between increased celiac markers and CP.

Adolescent↗