Children with Untreated Food Allergy Express a Relative Increment in the Density of Duodenal ?d+ T Cells

Kokkonen, Kati

doi:10.1080/003655200750056592

Cited by 73 publications

(30 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A patchy enteropathy was found in 60% of patients with cows’ milk allergy, in all cases characterized by duodenal lymphocytosis [56]. A striking increase in γ/δ-positive T-cells has been reported in such patients [57,58]. Further diagnostic clues are increased eosinophils and the association with clinical manifestations of an allergic phenotype.…”

Section: Origin Of Mementioning

confidence: 99%

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

Ierardi¹,

Losurdo²,

Iannone³

et al. 2017

aog

View full text Add to dashboard Cite

Microscopic enteritis (ME) is characterized by abnormal infiltration of intraepithelial lymphocytes in intestinal mucosa. It was described as duodenal lymphocytosis or lymphocytic duodenitis until the dedicated Consensus Conference of 2015. ME represents a common feature of several gluten-mediated and non-gluten related diseases; therefore, it is an umbrella term embracing several conditions. The most frequent causes of ME are gluten-related disorders (celiac disease, non-celiac gluten sensitivity, wheat allergy), Helicobacter pylori infection and drug-related damages. Less frequently, ME may be secondary to inflammatory bowel disease, some autoimmune conditions, immunoglobulin deficiencies, blood malignancies, infections and irritable bowel syndrome. Therefore, the differential diagnosis of ME may be challenging. The diagnosis of ME needs to be driven by predominant symptoms and patient history. However, it is often difficult to achieve an immediate identification of the underlying condition, and a broad variety of diagnostic tests may be required. Ultimately, long-term surveillance is needed for a final diagnosis in many cases, since a hidden or quiescent condition may be disclosed after a period of latency. In any case, strict collaboration between the clinician and the pathologist is pivotal. The treatment of ME should be personalized, depending on the underlying disease. For gluten-related conditions (celiac disease, gluten sensitivity, wheat allergy, dermatitis herpetiformis), a gluten-free diet may be proposed. For other conditions, a targeted etiologic treatment is necessary. In conclusion, ME represents a novel entity that is attracting increasing interest. The growing epidemiologic trend confirms that it will become a common condition in clinical practice.

show abstract

Section: Origin Of Mementioning

confidence: 99%

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

Ierardi¹,

Losurdo²,

Iannone³

et al. 2017

aog

View full text Add to dashboard Cite

show abstract

“…It was first described as an age-related finding in children of minimal significance, but further work noted a close association between LNH and the development of food allergies. It was shown that children with LNH were two to three times more likely to have non-IgE mediated allergies to food such as milk or cereal (Kokkonen et al, 1999) including high levels of IgG and IgA against milk proteins (Kokkonen et al, 2002), increased numbers of γδ T cells associated with the lymphoid follicles (Kokkonen et al, 2000), and increased CD4+ T cells with decreased T h1 cytokines (Bellanti et al, 2003). LNH was not found to be associated with Crohn’s disease or NOD2/CARD15 mutations raising speculation that LNH is not related to inflammatory disease, but may be a response to the microbial environment (Shaoul et al, 2006) as children with LNH showed a significant increase in number of bacteria adherent to the intestinal mucosa layer (Conte et al, 2006).…”

Section: Ilf Hyperplasia As a Sign Of Immune Dysfunctionmentioning

confidence: 99%

Isolated Lymphoid Follicles are Dynamic Reservoirs for the Induction of Intestinal IgA

Knoop¹,

Newberry²

2012

Front. Immun.

View full text Add to dashboard Cite

IgA is one of the most important molecules in the regulation of intestinal homeostasis. Peyer’s patches have been traditionally recognized as sites for the induction of intestinal IgA responses, however more recent studies demonstrate that isolated lymphoid follicles (ILFs) can perform this function as well. ILF development is dynamic, changing in response to the luminal microbial burden, suggesting that ILFs play an important role providing an expandable reservoir of compensatory IgA inductive sites. However, in situations of immune dysfunction, ILFs can over-develop in response to uncontrollable enteric flora, resulting in ILF hyperplasia. The ability of ILFs to expand and respond to help control the enteric flora makes this dynamic reservoir an important arm of IgA inductive sites in intestinal immunity.

show abstract

“…The γδ IEL increase is not totally specific to CD, since it has occasionally been found in other conditions such as cow’s milk intolerance, food allergy, cryptosporidiosis, giardiasis, Sjögren syndrome, and IgA deficiency [11]. However, the increase in γδ IEL in a minority of patients with these conditions tends to be mild and transient [16]. It has been stated that CD is the only disease in which γδ IEL are increased systematically, permanently, and intensely [11], [17]–[19].…”

Section: Introductionmentioning

confidence: 99%

Intestinal Intraepithelial Lymphocyte Cytometric Pattern Is More Accurate than Subepithelial Deposits of Anti-Tissue Transglutaminase IgA for the Diagnosis of Celiac Disease in Lymphocytic Enteritis

et al. 2014

View full text Add to dashboard Cite

Background & AimsAn increase in CD3+TCRγδ+ and a decrease in CD3− intraepithelial lymphocytes (IEL) is a characteristic flow cytometric pattern of celiac disease (CD) with atrophy. The aim was to evaluate the usefulness of both CD IEL cytometric pattern and anti-TG2 IgA subepithelial deposit analysis (CD IF pattern) for diagnosing lymphocytic enteritis due to CD.MethodsTwo-hundred and five patients (144 females) who underwent duodenal biopsy for clinical suspicion of CD and positive celiac genetics were prospectively included. Fifty had villous atrophy, 70 lymphocytic enteritis, and 85 normal histology. Eight patients with non-celiac atrophy and 15 with lymphocytic enteritis secondary to Helicobacter pylori acted as control group. Duodenal biopsies were obtained to assess both CD IEL flow cytometric (complete or incomplete) and IF patterns.ResultsSensitivity of IF, and complete and incomplete cytometric patterns for CD diagnosis in patients with positive serology (Marsh 1+3) was 92%, 85 and 97% respectively, but only the complete cytometric pattern had 100% specificity. Twelve seropositive and 8 seronegative Marsh 1 patients had a CD diagnosis at inclusion or after gluten free-diet, respectively. CD cytometric pattern showed a better diagnostic performance than both IF pattern and serology for CD diagnosis in lymphocytic enteritis at baseline (95% vs 60% vs 60%, p = 0.039).ConclusionsAnalysis of the IEL flow cytometric pattern is a fast, accurate method for identifying CD in the initial diagnostic biopsy of patients presenting with lymphocytic enteritis, even in seronegative patients, and seems to be better than anti-TG2 intestinal deposits.

show abstract

Children with Untreated Food Allergy Express a Relative Increment in the Density of Duodenal ?d+ T Cells

Cited by 73 publications

References 15 publications

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

Lymphocytic duodenitis or microscopic enteritis and gluten-related conditions: what needs to be explored?

Isolated Lymphoid Follicles are Dynamic Reservoirs for the Induction of Intestinal IgA

Intestinal Intraepithelial Lymphocyte Cytometric Pattern Is More Accurate than Subepithelial Deposits of Anti-Tissue Transglutaminase IgA for the Diagnosis of Celiac Disease in Lymphocytic Enteritis

Contact Info

Product

Resources

About