Duodenal intraepithelial lymphocytes in inflammatory disorders of the esophagus and stomach.
OBJECTIVE
Duodenal cluster designation 3 positive (CD3+) intraepithelial T lymphocytes (IELs) are increased in gluten-sensitive enteropathy (GSE) and, because of the dispersed nature of the gut immune system, might also be increased in mucosa distant from the duodenum. Conversely, little is known about their frequency in the duodenum during inflammatory conditions of the stomach and esophagus. This study assessed whether CD3+ IELs are increased in duodenal biopsies in patients with esophagitis or gastritis relative to normal control subjects.


METHODS
Cases (n=46) with concurrent mucosal biopsies of the duodenum, stomach, and esophagus were divided into 4 groups: I, no inflammation in any site; II, active esophagitis only; III, chronic active gastritis only, with Helicobacter pylori bacteria; IV, chronic gastritis only, without H pylori bacteria. Immunostains against CD3 were performed by using standard techniques, the number of CD3+ cells/100 enterocytes in 3 well-oriented villi was recorded, and the results for the groups were compared statistically.


RESULTS
The average number of CD3+ IELs/100 enterocytes for each group was I, 6.7; II, 11.8; III, 7.2; and IV, 9.1. The differences among the groups were not statistically significant. There was no correlation between the number of duodenal IELs and severity of inflammation, patient age or sex, or symptoms.


CONCLUSIONS
Duodenal mucosal biopsies from patients with esophagitis and/or gastritis may have a slightly increased number of CD3+ IELs relative to normal control subjects. This finding may reflect an underlying mechanism of diffuse inflammation in the gastrointestinal tract.
Yousef
Mohammad M
MM
Department of Pathology, UMass Memorial Healthcare, Worcester, Massachusetts 01605, USA.
Yantiss
Rhonda K
RK
Baker
Stephen P
SP
Banner
Barbara F
BF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D017252:CD3 Complex / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004378:Duodenal Diseases / Q000276:immunology* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000276:immunology* / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011336:Probability; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016176:T-Lymphocyte Subsets / Q000166:cytology / Q000276:immunology*
D017252:CD3 Complex