The histopathology of coeliac disease

Oberhuber, Georg; Granditsch, G; Vogelsang, Harald

doi:10.1097/00042737-199910000-00019

Cited by 1,452 publications

(270 citation statements)

References 0 publications

Supporting

Mentioning

258

Contrasting

Unclassified

Order By: Relevance

“…Clinical details of participants are shown in Table 1. The diagnosis of celiac disease was based on combination of clinical signs and typical small intestinal histological finding of villous atrophy according to the modified Marsh criteria (34). For all celiac disease patients, the clinical status improved and histological abnormalities normalized after treatment with gluten-free diet.…”

Section: Materials and Methods Subjects And Study Protocol Ten Dq2mentioning

confidence: 99%

Tetramer visualization of gut-homing gluten-specific T cells in the peripheral blood of celiac disease patients

Ráki

Fallang

Brottveit

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

141

166

View full text Add to dashboard Cite

Tetramers of MHC-peptide complexes are used for detection and characterization of antigen-specific T cell responses, but they require knowledge about both antigenic peptide and the MHC restriction element. The successful application of these reagents in human diseases involving CD4 ؉ T cells is limited. Celiac disease, an intestinal inflammation driven by mucosal CD4 ؉ T cells recognizing wheat gluten peptides in the context of disease-associated HLA-DQ molecules, is an ideal model to test the potential clinical use of these reagents. We investigated whether gluten-specific T cells can be detected in the peripheral blood of celiac disease patients using DQ2 tetramers. Nine DQ2 ؉ patients and six control individuals on a gluten-free diet were recruited to the study. Participants consumed 160 g of gluten-containing bread daily for 3 days. After bread-challenge, gluten-specific T cells were detectable in the peripheral blood of celiac patients but not controls both directly by tetramer staining and indirectly by enzyme-linked immunospot. These T cells expressed the ␤7 integrin indicative of gut-homing properties. Most of the cells had a memory phenotype, but many other phenotypic markers showed a heterogeneous pattern. Tetramer staining of gluten-specific T cells has the potential to be used for diagnosis of celiac disease. tetramers T he development of multimeric MHC-peptide complexes has revolutionized the analysis of antigen-specific T cell responses. Tetramers are such reagents consisting of four soluble recombinant MHC molecules, each loaded with a single peptide and bound to a streptavidin molecule that is coupled with a fluorogenic marker (1). Multivalent engagement of the MHCpeptide complexes leads to a stable binding of the tetramer to T cell receptors on the T cell surface, allowing direct visualization of T cells with a defined specificity.MHC class I tetramer technology has greatly facilitated our understanding of CD8 ϩ T cell responses in viral infections and cancer (2). The benefit of tetramers for characterization and diagnosis of human autoimmune and infectious diseases has, however, been modest (3-6). This particularly relates to MHC class II tetramers used for the characterization of antigen-specific CD4 ϩ T cells. Only a few studies of relevance to autoimmunity exist (7-9). MHC class II tetramers are more difficult to produce than MCH class I tetramers (10, 11), and CD4 ϩ T cells of a given specificity appear to be present at much lower frequencies than their CD8 ϩ counterparts (12, 13). Several criteria have to be met to be able to detect antigen-reactive T cells with MHC II tetramers: both the peptide epitope and HLA-restriction element have to be identified, and sufficient frequency and relative high avidity of reactive T cells are needed (14).Celiac disease, a chronic inf lammatory disorder of the small intestine precipitated by ingestion of cereal gluten proteins, presents as an ideal model to test the potential clinical use of MHC class II tetramers. The disorder is driven by intestinal glu...

show abstract

Section: Materials and Methods Subjects And Study Protocol Ten Dq2mentioning

confidence: 99%

Tetramer visualization of gut-homing gluten-specific T cells in the peripheral blood of celiac disease patients

Ráki

Fallang

Brottveit

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

141

166

View full text Add to dashboard Cite

show abstract

“…All patients underwent intestinal biopsy during endoscopy, with the histological examination of the small intestine specimens classified according MarshOberhüber scale [11] . Serum samples collected from all children and stored at -20 ℃ were used for antibody detection.…”

Section: Patientsmentioning

confidence: 99%

Clinical utility of quantitative multi-antibody Polycheck immunoassays in the diagnosis of coeliac disease

Konopka¹,

Grzywnowicz²,

Oralewska³

et al. 2016

WJGPT

View full text Add to dashboard Cite

AIM:To evaluate the clinical utility of multi-antibody strategies in the diagnosis of coeliac disease (CD), the new quantitative Polycheck immunoassays were analysed. METHODS: Retrospective StudyIgA or anti-DGP-IgG (in the case of IgA deficiency) antibodies, typical histopathological changes in duodenal mucosa described in Marsh-Oberhüber classification as at least grade 2. The diagnosis of the majority of the control subjects was functional gastrointestinal disorders. The PCP results were compared with reference EliA Celikey. RESULTS:The usage of PCPs led to the correct identification of all CD patients. In our study, PCPs showed 100% agreement with the histopathological results. PCP IgA test showed a 98% concordance and correlated positively (R = 0.651, P = 0.0014) withEliA Celikey test. The highest specificity and positive predictive value (both 100%) were observed for the detection of Polycheck anti-tTG-IgA antibodies. The highest sensitivity and negative predictive value (both 100%) were achieved by Polycheck anti-DGPIgG antibody detection. The best performance (98% sensitivity and negative predictive value, 100% specificity and positive predictive value, diagnostic accuracy -AU ROC 99%) was observed for the strategy of using both PCP IgA and IgG and determining positive outcomes of the test with two or more coeliac-specific antibodies detected. The majority of coeliac patients had multiple antibodies. All four antibodies were detected in 7 (14%) cases, 19 children (38%) were positive for three antibodies and 23 (46%) were positive for two antibodies. CONCLUSION:The present study showed that detection of coeliac-specific antibodies with multi-antibody PCPs is effective and efficacious in the diagnosis of CD.

show abstract

“…Lesions on biopsies consistent with Marsh-Oberhuber criteria (including increased intraepithelial lymphocytes, partial to complete villous atrophy) were considered to be diagnostic [19] . The duodenal biopsies were analysed within the same pathology laboratory, although by different pathologists.…”

Section: Populationmentioning

confidence: 99%

Presentation Patterns and Nutritional Impact of Coeliac Disease in New Zealand Children

Adamji

Whitehead

Day

2017

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

RESULTS:Over the study period, 110 children were diagnosed at mean age of 7.37 years. The most common presenting symptom was abdominal pain. Sixteen children were diagnosed following screening in high risk groups, with 14 being asymptomatic. Eighteen children were iron deficient and twelve vitamin D deficient. CONCLUSIONS: CD was diagnosed in children of all ages, with various presentation patterns. Micronutrient deficiencies were commonly seen at diagnosis. Ongoing assessment of patterns of CD in NZ children is required. INTRODUCTIONCoeliac disease (CD) is an autoimmune disease of the small bowel, triggered by dietary exposure to gluten in genetically susceptible individuals [1] . Ingestion of gluten provokes immune-mediated damage to the small intestinal mucosa. The optimal management of CD currently involves institution of a life-long gluten free diet (GFD) [2] . The features of CD can develop at any age whilst on a gluten containing diet [3] . CD can have variable presentations from gastrointestinal symptoms to non-specific symptoms such as headaches or lethargy [4][5][6] . In addition, many individuals are increasingly identified consequent to active screening in groups at higher risk of CD (such as those with positive family history or type 1 diabetes) and a number of these individuals may be asymptomatic at diagnosis [7] . CD appears to be increasing in prevalence in many countries around the world, including New Zealand [7] . A population-based study conducted in the Christchurch region of New Zealand in the last years of the 20 th century using electoral roll records, showed a prevalence of 1.2% [8] . A further study in the same region documented more individuals being diagnosed with CD each year [9] . Subsequently AIM:To evaluate the presentation patterns of a cohort of children diagnosed with coeliac disease at Christchurch Hospital, New Zealand. METHODS: Children aged 15 years or less diagnosed with CD (based upon standard histological criteria) over a five year period were identified retrospectively. Presenting symptoms, anthropometry, serology and micronutrients were reviewed.

show abstract

The histopathology of coeliac disease

Cited by 1,452 publications

References 0 publications

Tetramer visualization of gut-homing gluten-specific T cells in the peripheral blood of celiac disease patients

Tetramer visualization of gut-homing gluten-specific T cells in the peripheral blood of celiac disease patients

Clinical utility of quantitative multi-antibody Polycheck immunoassays in the diagnosis of coeliac disease

Presentation Patterns and Nutritional Impact of Coeliac Disease in New Zealand Children

Contact Info

Product

Resources

About