0000000000463505
AUTHOR
Sherly Mathews
GLOBAL TRANSLATION OF COELIAC DISEASE HISTOLOGY AND OTHER GLUTEN RELATED MICROENTEROPATHY
Introduction Intestinal epithelial cell damages generated by inflammation in coeliac disease (CD) ranges from sub-microscopic to severe architectural distortion. Translation of quantitative morphological changes in intestinal microorgans, like villus/crypt transformation, distribution of inflammatory cells and diagnostic cut offs, is lacking for CD and gluten related micro-enteropathies. Method Investigators from 22 centres, 9 countries of 4 continents, recruited CD patients with Marsh 0-II histology (n=299), NCGS (n=151), and 262 controls. Based on an agreed protocol, epithelial morphology including intraepithelial lymphocyte (IEL) density, villus height and crypt depth were measured in we…
Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity : A Multicentre Study
Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. \ud \ud \ud \ud Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). \ud \ud \ud \ud Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined. Villus height (VH, in μm), crypt depth (CrD, in μm), villus-to-crypt ratios (VCR), IELs (intraepithelial lymphocytes/100 enterocytes), and other relevant histological, serologic, and…
ROC-king onwards: intraepithelial lymphocyte counts, distribution & role in coeliac disease mucosal interpretation
ObjectivesCounting intraepithelial lymphocytes (IEL) is central to the histological diagnosis of coeliac disease (CD), but no definitive ‘normal’ IEL range has ever been published. In this multicentre study, receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off between normal and CD (Marsh III lesion) duodenal mucosa, based on IEL counts on >400 mucosal biopsy specimens.DesignThe study was designed at the International Meeting on Digestive Pathology, Bucharest 2015. Investigators from 19 centres, eight countries of three continents, recruited 198 patients with Marsh III histology and 203 controls and used one agreed protocol to count IEL/100 ent…