Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet
Considerable heterogeneity exists across studies assessing intestinal mucosal recovery in celiac (CD) patients on a gluten-free diet (GFD). We aimed at investigating histological and immunohistochemical features in CD patients on a long-term GFD and to correlate them to the GFD duration. Morphometri...
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MDPI AG
2022-09-01
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| Series: | Nutrients |
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| author | Roberta Mandile Mariantonia Maglio Caterina Mosca Antonella Marano Valentina Discepolo Riccardo Troncone Renata Auricchio |
| author_facet | Roberta Mandile Mariantonia Maglio Caterina Mosca Antonella Marano Valentina Discepolo Riccardo Troncone Renata Auricchio |
| author_sort | Roberta Mandile |
| collection | DOAJ |
| description | Considerable heterogeneity exists across studies assessing intestinal mucosal recovery in celiac (CD) patients on a gluten-free diet (GFD). We aimed at investigating histological and immunohistochemical features in CD patients on a long-term GFD and to correlate them to the GFD duration. Morphometrical and immunohistochemical analysis were retrospectively performed on duodenal biopsies in three groups of children: 33 on a long-term (>2 years) GFD (GFD-group), four of which remained seropositive despite dietary adherence, 31 with villous atrophy (ACD-group) and 76 heathy, non-celiac (CTR-group). Moreover, in the GFD-group, we correlated immunohistochemical alterations to the GFD duration. The villous to crypt (V/C) ratio significantly improved after the GFD and completely normalized in all patients, becoming even higher than in the CTR-group (median value 3.2 vs. 3, <i>p</i> = 0.007). In parallel, the number of CD3+ and TCRγδ+ cells in the epithelium were significantly reduced in the GFD compared to ACD patients, even if they remained higher than in the CTR-group (<i>p</i> < 0.05). In contrast, CD25+ cells in the lamina propria significantly decreased after the GFD (<i>p</i> < 0.05) and become comparable to the CTR-group (<i>p</i> = 0.9). In the GFD-group there was no difference in the immunohistochemical parameters between seropositive and seronegative patients and alterations did not correlate to GFD length. In conclusion, a GFD is able to both restore a normal V/C ratio and reduce inflammation, but the epithelium maintains some stigmata of the disorder, such as an increased number of CD3+ and TCRγδ+ cells. These alterations persist regardless of the duration of the GFD. |
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| series | Nutrients |
| spelling | doaj.art-053a935283324811b52fb3f8feb3820c2023-11-23T18:10:11ZengMDPI AGNutrients2072-66432022-09-011418369610.3390/nu14183696Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free DietRoberta Mandile0Mariantonia Maglio1Caterina Mosca2Antonella Marano3Valentina Discepolo4Riccardo Troncone5Renata Auricchio6Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, ItalyEuropean Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, ItalyDepartment of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, ItalyEuropean Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, ItalyDepartment of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, ItalyDepartment of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, ItalyDepartment of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, ItalyConsiderable heterogeneity exists across studies assessing intestinal mucosal recovery in celiac (CD) patients on a gluten-free diet (GFD). We aimed at investigating histological and immunohistochemical features in CD patients on a long-term GFD and to correlate them to the GFD duration. Morphometrical and immunohistochemical analysis were retrospectively performed on duodenal biopsies in three groups of children: 33 on a long-term (>2 years) GFD (GFD-group), four of which remained seropositive despite dietary adherence, 31 with villous atrophy (ACD-group) and 76 heathy, non-celiac (CTR-group). Moreover, in the GFD-group, we correlated immunohistochemical alterations to the GFD duration. The villous to crypt (V/C) ratio significantly improved after the GFD and completely normalized in all patients, becoming even higher than in the CTR-group (median value 3.2 vs. 3, <i>p</i> = 0.007). In parallel, the number of CD3+ and TCRγδ+ cells in the epithelium were significantly reduced in the GFD compared to ACD patients, even if they remained higher than in the CTR-group (<i>p</i> < 0.05). In contrast, CD25+ cells in the lamina propria significantly decreased after the GFD (<i>p</i> < 0.05) and become comparable to the CTR-group (<i>p</i> = 0.9). In the GFD-group there was no difference in the immunohistochemical parameters between seropositive and seronegative patients and alterations did not correlate to GFD length. In conclusion, a GFD is able to both restore a normal V/C ratio and reduce inflammation, but the epithelium maintains some stigmata of the disorder, such as an increased number of CD3+ and TCRγδ+ cells. These alterations persist regardless of the duration of the GFD.https://www.mdpi.com/2072-6643/14/18/3696mucosal healinggluten-free dietimmunohistochemistryvillous architecture |
| spellingShingle | Roberta Mandile Mariantonia Maglio Caterina Mosca Antonella Marano Valentina Discepolo Riccardo Troncone Renata Auricchio Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet Nutrients mucosal healing gluten-free diet immunohistochemistry villous architecture |
| title | Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet |
| title_full | Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet |
| title_fullStr | Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet |
| title_full_unstemmed | Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet |
| title_short | Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet |
| title_sort | mucosal healing in celiac disease villous architecture and immunohistochemical features in children on a long term gluten free diet |
| topic | mucosal healing gluten-free diet immunohistochemistry villous architecture |
| url | https://www.mdpi.com/2072-6643/14/18/3696 |
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