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 TCR??:TCR?? 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+?? 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.
ABSTRACT
Sijunzi Decoction polysaccharide (SJZDP) is the active component contributing to the function of intestinal immunoregulation, which is the highest content in Sijunzi Decoction. SJZDP can activate immunological response in peyer’s patch, mesenteric lymph nodes, intestinal epithelial cells and intestinal intraepithelial lymphocytes, but the mechanism is unknown. The reported mechanisms of SJZDP’s intestinal immunoregulation activity are related to its regulation of intestinal flora and polyamine signaling pathway. This review is to give a comprehensive summary of information regarding the intestinal immunoregulation of SJZDP and mechanism to help us take the action for reasonable clinical utilization and further researches.
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Objective: To explore and modify the isolation method for mouse intestinal intraepithelial lymphocytes. Methods: Epithelium mucosae of mouse small intestine was incubated in iced bath and shaked in PBS containing DTT. The cell suspension was obtained after filtration with 80 and 400- screen mesh trap valve in turn. The yield, viability and purity of intestinal intraepithelial lymphocytes were observed to estimate the feasibility. Results: About (5.6±0.7)×10～6 intestinal intraepithelial lymphocytes were obtained from every 20cm samll intestine. The viabilty of intestinal intraepithelial lymphocytes was (90.46±5.71)% and the purity was (92.21±5.20)%. Conclusion: Compared with other reported isolation methods, the modifled method is convenient and esay to handling.The yield, viability and purity are high enough to be used for intestinal intraepithelial lymphocytes studies.
ABSTRACT
BACKGROUND/AIMS: Our aims were to establish the clinical utility of assessing the intraepithelial lymphocyte (IEL) density in intestinal biopsies from a large series of individuals and to determine the best threshold discriminating celiac disease (CD) patients and controls in two populations with different pre-test prevalence. METHODS: We prospectively performed intestinal biopsy and CD-related serology in 349 subjects undergoing upper GI endoscopy. While 116 had symptoms suggestive of a small bowel disorder (high prevalence), 233 individuals were randomly selected from patients referred to endoscopy because upper GIsymptoms (low prevalence). Diagnosis of CD was based on the concordance of classical histological features and a positive CD serology. RESULTS: While 58 patients had a newly diagnosed CD (52 in the high and 6 in the low prevalence groups), 291 subjects did not meet diagnostic criteria of the disorder. Patients had a highly significant greater IEL density than controls (p < 0.00001). Based on the ROC curve, a count of 22.8 IEL/100 epithelial cells had the highest performance for diagnosing CD in the overall population and for subjects in the high pre-test probability subgroup and 22.5% was ,he best cut-off for those diagnosed in the low risk population (area under the curves: 0.979, 0.979 and 0.993, respectively). An abnormal CD serology confirmed the diagnosis of CD in all the four patients with counts below 22.8%. CONCLUSIONS: Our study confirms that an IEL density of 22.8% is an adequate threshold to discriminate CD patients and controls in individuals irrespective of the prevalence of the disorder.
Introducción: El recuento elevado de linfocitos intraepiteliales (LIEs) es un rasgo destacado aunque inespecífico de la enteropatía de la enfermedad celíaca (EC). Un recuento mayor a 40 LIEs/100 células epiteliales ha sido considerado por mucho tiempo esencial para el diagnóstico. Sin embargo, estudios recientes con escaso número de muestras han cuestionado este valor de corte. Objetivos: Determinar el rango normal de LIEs en biopsias intestinales y establecer su capacidad diagnóstica de EC en dos poblaciones con diferente prevalencia. Métodos: Realizamos prospectivamente biopsias de duodeno distal y serología para EC en 349 pacientesconsecutivos a quienes se les realizó una videoendoscopia digestiva alta. El grupo A consistió en 116 pacientes derivados a biopsia intestinal por síntomas sugestivos de malabsorción (considerados de alta prevalencia de EC) y el grupo B consistió en 233 pacientes randomizados entre quienes fueron derivados a endoscopía alta por síntomas gastrointestinales no sugestivos de EC (baja prevalencia de EC). El diagnóstico de EC se basó en criterios histológicos clásicos y serología positiva. Resultados: Cincuenta y ocho pacientes tuvieron EC (52 en el grupo de alto riesgo y 6 en el de baja prevalencia) y 291 individuos no tuvieron criterios de la enfermedad. Los pacientes tuvieron una densidad de LIEs significativamente mayor que los controles (p<0.00001). Basado en las curvas ROC, el conteo de 22.8 LIEs/100 células epiteliales tuvo la mejor sensibilidad y especificidad para el diagnóstico de EC en la población general y entre los sujetos con alta probabilidad y 22.5% fue el mejor valor de corte para la población de bajo riesgo (áreas bajo las curvas: 0.979, 0.979 y 0.993, respectivamente). Todos aquellos pacientes celíacos con recuento de LIEs por debajo de 22% (n=4), tuvieron serología positiva para EC. El clásico valor de 40% tuvo una sensibilidad del 55%. Conclusiones: Nuestro estudio confirma que una...
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged, 80 and over , Celiac Disease/diagnosis , Intestinal Mucosa/cytology , Biopsy , Lymphocyte Count , ROC Curve , Celiac Disease/immunology , Prospective Studies , Case-Control Studies , Sensitivity and Specificity , Predictive Value of TestsABSTRACT
Objective To imestigate the effect of total polysaccharides(TP) from Sijunzi Decoction(SD) on the immune function of mice intestinal intraepithelial lymphocytes(iIEL).Methods NIH mice were eaqually randomized to 4 groups:control group,model group,TP-SD group,free-protein polysaccharides from SD(FPP-SD) group.Mice iIEL was extracted by discontinuous density method.The percentage of CD3+ and CD69+ in iIEL were detected by flow cytometer.IL-2 and IFN-? expression in iIEL supernatant was detected by ELISA.Results The percentage of CD3+ lymphocyte in iIEL was 88.46 %.The percentage of CD69+ lymphocyte and the levels of IL-2 and IFN-? in iIEL were significantly decreased in the model group compared with those in the normal control group(P