title: Morphometric studies in duodenal biopsies from patients with coeliac disease: the effect of the steroid fluticasone propionate.
abstract: Morphometric measurements have been performed on small intestinal biopsy specimens from patients with untreated coeliac disease before and after six weeks oral treatment with a steroid of low systemic bioavailability (fluticasone propionate). Measurements were obtained by point counting and also by a computer-aided measuring system with reference to a constant area of the muscularis mucosa. Fluticasone propionate led to a parallel reduction in the intraepithelial lymphocyte count within the surface (P less than 0.001) and crypt epithelium (P less than 0.01). The intra-epithelial lymphocyte count assessed by reference to constant areas of the muscularis mucosa and surface epithelium were decreased two-fold (P less than 0.01) and seven-fold (P less than 0.001) respectively. Fluticasone propionate treatment also led to significant increases in the absorptive surface epithelium as shown by an increase in the villus:crypt ratio (P less than 0.01), the epithelial cell height (P less than 0.01) and two- to three-fold increases in the area and length of the surface epithelium (P less than 0.001). Short-term fluticasone propionate treatment appears to exert a powerful beneficial effect upon duodenal morphology in patients with coeliac disease. Whether the alterations seen are comparable to a similar period of gluten withdrawal is not yet known.
authors.affiliation: Gastroenterology Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Zaitoun
authors.forename: C O
authors.initials: CO
authors.lastname: Record
mesh_terms: D000328:Adult; D000730:Androstadienes / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001706:Biopsy; D002446:Celiac Disease / Q000188:drug therapy / Q000473:pathology*; D004386:Duodenum / Q000473:pathology*; D000068298:Fluticasone; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008214:Lymphocytes / Q000187:drug effects; D012044:Regression Analysis; D013194:Staining and Labeling
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone