title: Colonic involvement in celiac disease and possible implications of the sigmoid mucosa organ culture in its diagnosis.
abstract: OBJECTIVE
  Celiac disease (CD), a systemic autoimmune disorder that typically involves duodenal mucosa, can also affect other intestinal areas. Duodenal and oral mucosa organ culture has already been demonstrated as a reliable procedure to identify CD. The present study investigated gluten-dependent immunological activation of colonic mucosa in CD patients. We took advantage of the numerous colonoscopies performed for various clinical conditions or only for defensive medicine.
  
  
  METHODS
  Forty-four patients with gastrointestinal symptoms or in need of colorectal cancer screening were divided into patients with serum anti-endomysium (EMA) and anti-tissue transglutaminase (anti-tTG) antibody positive results (Group A), patients with serum antibody negative results (Group B), and patients with inflammatory bowel disease (IBD) (Group C). The autoantibodies EMA and anti-tTG were evaluated in supernatants of cultured sigmoid and duodenal biopsies from patients on a gluten-containing diet.
  
  
  RESULTS
  In Group A, EMA and anti-tTG resulted positive in all duodenal culture supernatants. In sigmoid culture supernatants, EMA and anti-tTG were detected in 12/16 (75 %) and 13/16 (81.3 %) patients, respectively. In Group B, none of the 17 patients showed EMA and anti-tTG positive results in both duodenal and sigmoid cultures. In Group C, all 11 patients presented EMA negative results in sigmoid cultures. Only in one patient, anti-tTG were detectable in the sigmoid culture supernatant, as expected in cases of IBD.
  
  
  CONCLUSIONS
  Data confirm that the gluten-dependent immunological activation affects more intestinal tracts with different degrees of involvement, suggesting that the organ culture of colonic biopsies could represent a new tool to opportunistically detect CD.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University - Polyclinic Umberto I, Viale del Policlinico, 155, 00161, Rome, Italy, antonio.picarelli@uniroma1.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Picarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Di Tola
authors.forename: Raffaele
authors.initials: R
authors.lastname: Borghini
authors.forename: Claudia
authors.initials: C
authors.lastname: Isonne
authors.forename: Annarita
authors.initials: A
authors.lastname: Saponara
authors.forename: Mariacatia
authors.initials: M
authors.lastname: Marino
authors.forename: Rossella
authors.initials: R
authors.lastname: Casale
authors.forename: Antonio
authors.initials: A
authors.lastname: Tiberti
authors.forename: Roberta
authors.initials: R
authors.lastname: Pica
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Donato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frieri
authors.forename: Enrico
authors.initials: E
authors.lastname: Corazziari
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000378:metabolism*; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002478:Cells, Cultured; D012809:Colon, Sigmoid / Q000276:immunology* / Q000473:pathology; D003113:Colonoscopy; D003238:Connective Tissue / Q000276:immunology; D005260:Female; D005983:Glutens / Q000276:immunology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000276:immunology*; D009924:Organ Culture Techniques; D012698:Serologic Tests / Q000639:trends; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D005983:Glutens; D011503:Transglutaminases