Cell Density Counts of the Intestinal Intraepithelial Lymphocytes in the Celiac Patients
<strong>Background:</strong> Increased number of intestinal intraepithelial lymphocytes (IELs) is a key histological finding in the diagnosis of celiac disease (CD); however, the number of IELs in celiac patients and healthy subjects may vary from one region to another. Additionally, the...
Main Authors: | , , , , |
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Format: | Article |
Language: | English |
Published: |
Shiraz University of Medical Sciences
2019-06-01
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Series: | Iranian Journal of Immunology |
Subjects: | |
Online Access: | http://iji.sums.ac.ir/article_44937_b3bbc0b60d8d4bb742325ab9d255d813.pdf |
Summary: | <strong>Background:</strong> Increased number of intestinal intraepithelial lymphocytes (IELs) is a key histological finding in the diagnosis of celiac disease (CD); however, the number of IELs in celiac patients and healthy subjects may vary from one region to another. Additionally, there are some seronegative celiac patients with a borderline histology. <strong>Objective: </strong>To determine the number of the CD3<sup>+</sup> and CD8<sup>+</sup> IELs T-cells in the celiac patients and healthy subjects (controls) in Isfahan. <strong>Methods:</strong> The duodenal biopsies were obtained from the celiac patients (n=15) and the controls (n=19). The total number of IELs/100 epithelial cells (ECs) were counted using the hematoxylin-eosin (H&E) staining method, and that of CD3<sup>+</sup> and CD8<sup>+</sup> IELs/100 ECs were counted using the immunohistochemistry (IHC) staining method. <strong>Results:</strong> This study defined the upper normal limit for each variable as mean + 2SD. Accordingly, the upper normal limits of the total IELs, CD3<sup>+</sup> IELs, and CD8<sup>+ </sup> IELs/100 ECs were calculated as 37 (95% confidence intervals, CI: 33–41), 22 (95% CI: 19–25) and 12 (95% CI: 10–14), respectively. In 3 clinically CD diagnoses, the total IELs counts/100 ECs were below the upper normal limit, and the histopathological and serologic assays were negative. Nevertheless, the CD8<sup>+</sup> IELs T-cells counts/100 ECs showed borderline values. Interestingly, these patients responded to a gluten-free diet (GFD). <strong>Conclusions: </strong>The study findings suggest that in the clinically diagnosed celiac disease, IELs count/100 ECs below the upper normal limit as well as negative histopathological and serologic assays and the cell density counts of the CD8<sup>+</sup> IELs T-cells/100 ECs could be a useful parameter for CD diagnosis and make a decision to put them on a GFD. |
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ISSN: | 1735-1383 1735-367X |