Quantitation of intraepithelial lymphocytes in human duodenum: What is normal?

Hayat, Mumtaz; Cairns, Alison; O’Mahony, Seamus; Dixon, M. F.

doi:10.1016/s0016-5085(00)83576-3

Cited by 45 publications

(64 citation statements)

References 3 publications

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“…An increased number of IELs in CD was first recognised by Ferguson et al in 1971 [1], who established an upper pathological count of 40 IEL per 100 enterocytes. This value has been revised afterwards by morphometric [2,3] and immunohistochemical analysis [3], lowering the limits of normal values to 25 IEL per 100 enterocytes.…”

Section: Discussionmentioning

confidence: 99%

“…2 Percentage of TcRγ δ and CD3 − relative to the total number of IELs. * Student's t-test = 6.43 df = 69.…”

Section: Flow Cytometrymentioning

confidence: 99%

“…In 1971, Ferguson et al showed, by histological techniques, that IEL numbers were increased in active CD [1] and established an upper normal limit of 40 IEL/100 epithelial cells. Recent publications reevaluated this parameter by immunohistochemistry, lowering the limit to 20-25 IEL/100 epithelial cells [2][3][4]. Table 1 Final diagnosis, number of cases, age and mean values (with standard error in parentheses) of total number of duodenal intraepithelial lymphocytes of the subjects included as controls of healthy duodenal mucosa An increase in IELs is a hallmark index in the histological diagnosis of CD [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Age-Related Variation of Intraepithelial Lymphocytes Subsets in Normal Human Duodenal Mucosa

et al. 2007

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The enumeration of intestinal intraepithelial lymphocytes (IELs), and the phenotyping of CD3+CD 103+ (TcRalphabeta, TcRgammadelta) and CD3-CD103+ IEL subsets constitute useful diagnostic tools for the correct interpretation of the mucosal histology of duodenal/jejunal biopsies in many pathological conditions of the small intestine, particularly celiac disease (CD). This work evaluates the ranges of duodenal IEL counts by flow cytometry in healthy mucosa from pediatric and adult controls, establishing normal reference values for CD3+ TcRgammadelta and CD3- subsets and their variation with age. Seventy-four pediatric controls and 36 adult controls were identified on the basis of their normal histology from more than 1,000 duodenal diagnostic biopsies performed in Caucasian subjects. Total IEL counts and IEL subsets ("IEL lymphogram") were analyzed by four-color flow cytometry (FCM). IEL represent 7.7% +/- 0.4 (mean +/- SE) and 8.5% +/- 0.5 of the cells isolated from the epithelium in the pediatric and adult series, respectively. The upper normal range, considered as the 97 percentile, is 14% in pediatrics and 15% in adults. No significant difference was observed between TcRgammadeltaIEL percentages in children (6.9% +/- 0.5 of the total IELs) and adults (6.6% +/- 0.8). However, the density of CD3- IELs is significantly higher (p < 0.001) in the mucosa from controls under 3 years (50.2% +/- 2.6) than in adults (25.5% +/- 2.1). IEL lymphogram by flow cytometry is an easy, quick and reliable analysis performed in one of the biopsy specimens obtained during a diagnostic endoscopy, and confers specificity to the histopathological findings. IEL counts below 14% in children and 15% in adults should be considered within a normal range in the evaluation of duodenal mucosa by FCM. No differences with age were observed with respect to TcRgammadeltaIEL, while the CD3- IEL fraction was significantly higher on children under 3 years, with a trend to increase again in the elderly.

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Section: Discussionmentioning

confidence: 99%

“…2 Percentage of TcRγ δ and CD3 − relative to the total number of IELs. * Student's t-test = 6.43 df = 69.…”

Section: Flow Cytometrymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age-Related Variation of Intraepithelial Lymphocytes Subsets in Normal Human Duodenal Mucosa

et al. 2007

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“…As for the cut-off of intraepithelial lymphocytes, we used the cut-off of 25/100 according to Hayat et al [12] and Dickson et al [13].…”

Section: Methodsmentioning

confidence: 99%

Effect of Gluten-Free Diet on Pregnancy Outcome in Celiac Disease Patients with Recurrent Miscarriages

et al. 2008

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“…For the cutoff for intraepithelial lymphocytes, we used 25/100 according to Hayat et al [15] and Dickson et al [16]. Other possible causes of villous atrophy or duodenal damage, such as Giardia lamblia infestation, tropical sprue, collagenous sprue, food protein hypersensitivity (cow's milk, eggs, fish, rice, chicken) were excluded, as well as any other causes of inflammatory infiltration of duodenum, such as peptic duodenitis, were excluded before making diagnosis of celiac disease [17].…”

Section: Histological Classificationmentioning

confidence: 99%

Complications in Celiac Disease Under Gluten-Free Diet

et al. 2008

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We assessed the onset of malignant and nonmalignant complications in a cohort of celiac disease (CD) patients under gluten-free diet (GFD). Five hundred and forty-nine CD patients were retrospectively assessed. Two hundred and fifty-one (45.7%) showed classical, 262 (47.7%) subclinical, and 36 (6.6%) silent form of CD at the time of the diagnosis. The mean time under GFD was 7.13 years (range 1-15 years). Out of 549 patients, 381 (69.4%) were fully compliant, 112/549 (20.4%) reported less than one dietary transgression/month, and 56/549 (10.2%) reported at least one dietary transgression/month. Out of 549 patients, 18 (3.3%) patients developed complications under GFD (seven malignant and 11 nonmalignant complications). Fourteen patients were previously affected by classical CD (5.6% of the overall patients with classical CD), and four were affected by subclinical CD (1.5% of the overall patients with subclinical CD). None of the patients affected by silent CD developed complications. There was no statistical difference between the mean age of the two groups developing complications (P = n.s.). Complications appeared after a mean time under GFD of 6.5 years in classical CD, and after a mean time of 3.5 years in subclinical CD (P = n.s.). Finally, 6/14 (42.8%) patients with classical CD were not fully compliant to GFD, while 2/4 (50%) of subclinical CD patients were not fully compliant to GFD (P = n.s.). Less than 5% of CD patients may develop complications under GFD. Complications seem to affect more classical CD than subclinical CD, and seem to be irrespective of optimal GFD adherence.

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Quantitation of intraepithelial lymphocytes in human duodenum: What is normal?

Cited by 45 publications

References 3 publications

Age-Related Variation of Intraepithelial Lymphocytes Subsets in Normal Human Duodenal Mucosa

Age-Related Variation of Intraepithelial Lymphocytes Subsets in Normal Human Duodenal Mucosa

Effect of Gluten-Free Diet on Pregnancy Outcome in Celiac Disease Patients with Recurrent Miscarriages

Complications in Celiac Disease Under Gluten-Free Diet

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