title: Expression of HSP-65 in jejunal epithelial cells in patients clinically suspected of coeliac disease.
abstract: BACKGROUND
  Coeliac disease (CD) can be classified both clinically and biologically an autoimmune disease. A close relationship obtains between heat shock proteins (HSPs) and numerous autoimmune diseases. HSPs are overexpressed when protecting the host against environmental insult. We sought here to establish whether dietary gluten is such a stress stimulus in patients clinically suspected of CD, and whether the expression of HSP-65 associates with densities of intraepithelial gammadelta+ T cells and/or with expression of mucosal HLA-DR.
  
  
  METHODS
  Seventy-eight children with clinical suspicion of CD underwent a jejunal biopsy. Monoclonal antibodies were used to stain jejunal epithelial HSP-65, intraepithelial lymphocytes and mucosal HLA-DR. Serum IgA-class endomysial autoantibodies (EMA) were measured by an indirect immunofluorescence method. CD susceptibility HLA DQA1*0501 and DQB1*0201 alleles (HLA DQ2) were determined.
  
  
  RESULTS
  Enhanced expression of epithelial cell mitochondrial HSP-65 was found in 80% (16/20) of coeliacs and in 24% (14/58) of children excluded for the disease, but in only 7% (2/28) of control subjects (p < 0.001, p = 0.049, respectively). Children with enhanced expression of HSP-65 had significantly higher gammadelta+ T cell densities than those with normal HSP-65 expression. A clear association between HSP-65 and serum IgA-class EMA were also ascertained in patients with normal jejunal mucosal morphology. HLA DQ2 positivity did not correlate with the HSP-65 expression.
  
  
  CONCLUSIONS
  Gluten might be an environmental insult not only in CD patients but also in some patients excluded for the disease on biopsy. Enhanced expression of epithelial cell stress proteins might be an indicator of such an insult.
authors.affiliation: Institute of Medical Technology, University of Tampere, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Iltanen
authors.forename: I
authors.initials: I
authors.lastname: Rantala
authors.forename: P
authors.initials: P
authors.lastname: Laippala
authors.forename: K
authors.initials: K
authors.lastname: Holm
authors.forename: J
authors.initials: J
authors.lastname: Partanen
authors.forename: M
authors.initials: M
authors.lastname: Maki
mesh_terms: D000293:Adolescent; D001323:Autoantibodies; D001426:Bacterial Proteins; D002446:Celiac Disease / Q000276:immunology* / Q000378:metabolism* / Q000473:pathology; D018834:Chaperonin 60; D018833:Chaperonins / Q000096:biosynthesis* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003238:Connective Tissue / Q000276:immunology; D004847:Epithelial Cells / Q000737:chemistry* / Q000276:immunology / Q000473:pathology; D005260:Female; D015870:Gene Expression; D005983:Glutens / Q000008:administration & dosage / Q000009:adverse effects*; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens / Q000096:biosynthesis; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000276:immunology; D007583:Jejunum / Q000276:immunology / Q000473:pathology*; D008297:Male; D008928:Mitochondria / Q000737:chemistry; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis; D013601:T-Lymphocytes / Q000737:chemistry
chemical_list: D001323:Autoantibodies; D001426:Bacterial Proteins; D018834:Chaperonin 60; D006683:HLA-DQ Antigens; D006684:HLA-DR Antigens; D016692:Receptors, Antigen, T-Cell, gamma-delta; C074119:heat-shock protein 65, Mycobacterium; D005983:Glutens; D018833:Chaperonins