Antigen-Antibody Reactions in Jejunal Mucosa in Childhood Cœliac Disease After Gluten Challenge

Immunoglobulins in the jejunal mucosa in adult coeliac disease and dermatitis herpetiformis after the reintroduction of dietary gluten.

“…This is almost certainly caused by the relatively low pre-challenge levels in the adults rather than the length of the re-exposure, as even untreated adult patients on long-standing gluten containing diets usually have low (Douglas et al, 1970;Pettingale, 1971) or normal (Soltoft, 1970;Lancaster-Smith et al, 1974) densities of IgA cells. Further evidence that gluten stimulates jejunal IgA production and secretion is the increase in epithelial cell and extracellular IgA in both adults and children (Shiner and Ballard, 1972;Lancaster-Smith et al, 1976) after widely varying types of challenge.…”

“…Before gluten challenges they had villous heights ranging from 290-517 u (mean 389 ,u) (Stewart et al, 1967) and intraepithelial lymphocytes were counted (Ferguson and Murray, 1971 (Savilahti, 1972) over an area 0 5 mm2 between the epithelium and muscularis mucosae. In the majority of biopsies the presence and degree of extracellular and epithelial cell staining were also recorded (Shiner and Ballard, 1972). All observations were made without prior knowledge of whether the section was from a pre-or post-challenge biopsy.…”

“…However, the increased numbers and abnormal predominance of IgM over IgA containing cells in the jejunal mucosa of patients with ACD (Crabb and Heremans, 1966;Douglas et al, 1970;Soltoft, 1970;Pettingale, 1971;Savilahti, 1972;Lancaster-Smith et al, 1974) suggest that humoral immune mechanisms may be involved. Additional evidence for this is provided by the ultrastructural changes (Shiner, 1973) and deposition of immunoglobulins in the small intestinal mucosa of treated patients (Shiner and Ballard, 1972;Doe et al, 1974) after gluten challenge. Furthermore, in vitro studies with coeliac jejunal mucosa have shown an increased synthesis of IgA and IgM after challenge with gluten (Loeb et al, 1971), much of this being antibody against gluten (Falchuk and Strober, 1974).…”

Antibodies in celiac disease: implications beyond diagnostics

“…45 Immediately thereafter, similar IgA deposits in the basement membrane area were reported in the small-bowel mucosa of untreated celiac patients in conjunction with increases in the number of immunoglobulin-containing cells. [46][47][48][49] Immunoelectron microscopic studies revealed heavy deposits of IgA in the basement membrane of surface epithelial cells, in crypt epithelium, around the subepithelial fibroblasts and in the walls of blood vessels in the intestinal mucosa of Antibodies in celiac disease S Caja et al 104 celiac patients.…”

Gluten-sensitive enteropathy. Immunoglobulin G heavy-chain (Gm) allotypes and the immune response to wheat gliadin.

“…This does not exclude the possibility that GAb is involved in mechanisms that damage the small intestine. GAb-mediated injury could be secondary to immune complex deposition in the intestine (i.e., GAb-gliadin immune complexes) (31,32) GAb was present in 22 of 30 (73%) GSE patients and 0 of 28 controls (P < 0.001). Among GSE patients, GAb was significantly associated with phenotypes having the Gm marker G2m(n) (P < 0.001).…”