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Date: | Sat, 30 Sep 1995 23:50:07 EST |
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<<Disclaimer: Verify this information before applying it to your situation.>>
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: Pathology of Celiac Disease :
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: by Salvatore Auricchio, MD summarized by Jim Lyles :
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Dr. Auricchio is Professor and Chairman of Pediatrics at the
University Frederico II in Naples, Italy.
CD manifests itself in the small intestine. A distinct pattern of
abnormalities has been observed [comments in braces have been added by
Jim Lyles]:
* villous atrophy [partial or complete flattening of the
finger-like projections in the small intestine]
* hyperplasia of the crypts of Lieberkuhn [the crypts under the
villi become highly elongated when compared with normal crypts]
* increased plasma cell and lymphocyte infiltration of the lamina
propria [more lymphocytes under the epithelial or outer layer of
the villi. Lymphocytes are the cells that fight off viruses,
etc.]
* increased intraepithelial lymphocytes [more lymphocytes within
the epithelial cells. The epithelial cells form the outer layer
of the intestine and allow nutrients to pass through from the
intestine into the bloodstream]
* abnormalities in the epithelial cells which become flattened,
cuboidal, and pseudo- stratified [layered].
It is possible to do an in vitro gliadin challenge. [This is a test
of the immune system response to gliadin done in a laboratory setting
with tissue samples.] This is done by applying gliadin peptides to
normal small intestinal mucosa from treated celiacs. This test is
very specific for celiac mucosa and gliadin peptides. If you apply
the same gliadin peptides to small intestinal mucosa from non-celiacs,
there is no immune system response. Also, if you apply corn prolamin
peptides (which are not toxic to celiacs) to mucosa from treated
celiacs, there is no immune system response.
The in vitro gliadin challenge is suitable for reproducing various
immunological features observed in the classic celiac mucosal lesion.
This provides a model for studying immuno- mediated disease in which
the antigen is well known. This model may help us to understand the
pathogenetic mechanism that leads to the disease, which in turn may
help in defining new therapies for treating the disease.
There were a lot of technical details and discussion which I will not
attempt to summarize.
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