Cell-mediated immune injury in the intestine.
Epithelial adaptation clearly occurs during the course of intestinal cell-mediated immune responses to alloantigens. The adaptive response is similar to that seen in a number of enteropathies, namely villus atrophy, crypt hypertrophy, and crypt cell hyperplasia. In human fetal gut, polyclonal activation of lamina propria CD4+ T cells produces the same epithelial adaptive responses. Although these data provide overwhelming evidence that cell-mediated immune responses can cause enteropathy, the demonstration of antigen-specific T cells in the lamina propria of patients with enteropathy is still lacking, even in a disease as well-characterized as celiac disease. Epithelial adaptation in experimental and clinical situations, however, must involve a change in the mechanisms and mediators involved in normal intestinal homeostasis, such as epidermal growth factor and transforming growth factor-alpha and -beta, and in the interactions between epithelial cells and the underlying stromal cells.
MacDonald
T T
TT
Department of Pediatric Gastroenterology, St. Bartholomew's Hospital, London, England.
Spencer
J
J
D000818:Animals; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D005333:Fetus / Q000276:immunology; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007153:Immunologic Deficiency Syndromes / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000276:immunology / Q000473:pathology; D007413:Intestinal Mucosa / Q000276:immunology* / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000637:transplantation; D010581:Peyer's Patches / Q000473:pathology