In vitro-deranged intestinal immune response to gliadin in type 1 diabetes.
Dietary gluten has been associated with an increased risk of type 1 diabetes. We have evaluated inflammation and the mucosal immune response to gliadin in the jejunum of patients with type 1 diabetes. Small intestinal biopsies from 17 children with type 1 diabetes without serological markers of celiac disease and from 50 age-matched control subjects were examined by immunohistochemistry. In addition, biopsies from 12 type 1 diabetic patients and 8 control subjects were cultured with gliadin or ovalbumin peptic-tryptic digest and examined for epithelial infiltration and lamina propria T-cell activation. The density of intraepithelial CD3(+) and gammadelta(+) cells and of lamina propria CD25(+) mononuclear cells was higher in jejunal biopsies from type 1 diabetic patients versus control subjects. In the patients' biopsies cultured with peptic-tryptic gliadin, there was epithelial infiltration by CD3(+) cells, a significant increase in lamina propria CD25(+) and CD80(+) cells and enhanced expression of lamina propria CD54 and crypt HLA-DR. No such phenomena were observed in control subjects, even those with celiac disease-associated HLA haplotypes. In conclusion, signs of mucosal inflammation were present in jejunal biopsies from type 1 diabetic patients, and organ culture studies indicate a deranged mucosal immune response to gliadin.
Auricchio
Renata
R
Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy. reauricc@tin.it
Paparo
Francesco
F
Maglio
Maria
M
Franzese
Adriana
A
Lombardi
Francesca
F
Valerio
Giuliana
G
Nardone
Gerardo
G
Percopo
Selvaggia
S
Greco
Luigi
L
Troncone
Riccardo
R
D000293:Adolescent; D000917:Antibody Formation; D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006680:HLA Antigens / Q000032:analysis / Q000145:classification; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000276:immunology*; D007583:Jejunum / Q000276:immunology / Q000473:pathology; D008297:Male; D009924:Organ Culture Techniques
D006680:HLA Antigens; D005903:Gliadin