Intraepithelial lymphocytes subsets in different forms of celiac disease.
OBJECTIVE
The enumeration of intraepithelial lymphocytes subsets (total, γδ, and CD3(-) IELs) by flow cytometry (FCM), named as IEL lymphogram, constitutes a useful tool for celiac disease (CD) diagnosis. The aim of this study was to quantify IELs by FCM and their diagnostic value to differentiate active, silent and potential CD.


METHODS
Prospective study of 60 active and 20 silent CD patients, and 161 controls in which duodenal biopsy and IEL quantification by FCM was performed.


RESULTS
Active and silent CD patients had significant higher levels of both total and γδ IELs than absent CD patients (P < 0.0001 and P < 0.0001, P = 0.012 and P < 0.011; respectively). Active and silent CD patients had significant lower levels of CD3(-) IELs than absent CD patients (P < 0.047 and P < 0.009, respectively). Moreover, they were lower in silent than in active CD patients (P = 0.002). Changes of IELs subsets were more marked in children than adults active CD. The optimal IEL lymphogram cut off values for active CD diagnosis were: ≥10, ≥15 and ≤9 %, and with better performance characteristics for silent CD: ≥ 11, ≥10 and ≤5 %.


CONCLUSIONS
The evaluation of IELs subsets by FCM is useful to confirm diagnosis of active and silent CD.
Immunology Section, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008, Santander, Spain.
M
M
Sánchez-Castañon
Gastroenterology Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain.
B G
BG
Castro
Immunology Section, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008, Santander, Spain.
M
M
Toca
Immunology Section, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008, Santander, Spain.
C
C
Santacruz
Gastroenterology Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain.
M
M
Arias-Loste
Gastroenterology Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain.
P
P
Iruzubieta
Gastroenterology Service, Hospital Universitario Marqués de Valdecilla-IDIVAL, Santander, Spain.
J
J
Crespo
Immunology Section, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008, Santander, Spain. mlopezhoyos@humv.es.
Marcos
http://orcid.org/0000-0003-0562-427X
M
López-Hoyos
Active celiac disease; Flow cytometry; Intraepithelial lymphocytes; Silent celiac disease
J Clin Pathol. 2002 Jun;55(6):424-8
12037023
Am J Clin Pathol. 2004 Apr;121(4):546-50
15080306
Gut. 1991 Nov;32(11):1412-4
1836446
Gastroenterology. 2004 Apr;126(4):1217-8; author reply 1218-9
15057770
Gastroenterology. 2000 Jul;119(1):234-42
10889174
Gut. 1990 Apr;31(4):422-5
2338267
Clin Gastroenterol Hepatol. 2007 May;5(5):567-73
17428743
Pediatr Res. 1990 Dec;28(6):579-81
2149449
J Immunol Methods. 1993 Feb 3;158(2):207-14
8429227
Clin Exp Immunol. 1991 Jul;85(1):109-13
1829988
Am J Gastroenterol. 2003 Jun;98(6):1332-7
12818278
J Pediatr Gastroenterol Nutr. 2013 Mar;56(3):251-6
23111763
Rev Clin Esp. 2002 Sep;202(9):497-9
12236942
Lancet. 1992 Jun 20;339(8808):1500-3
1351185
Gut. 1989 Mar;30(3):339-46
2785074
Dig Dis Sci. 2007 Mar;52(3):685-91
17235707
J Pediatr Gastroenterol Nutr. 2010 Feb;50(2):140-6
19841593
J Immunol. 2005 May 1;174(9):5414-22
15843540
Cytometry. 1998 Apr 15;34(2):95-102
9579607
Semin Immunopathol. 2012 Jul;34(4):551-66
22660791
J Clin Pathol. 2004 Aug;57(8):835-9
15280404
Dig Dis Sci. 2008 Jul;53(7):1846-51
18080194
Acta Paediatr. 2000 Mar;89(3):285-90
10772275
Gut. 2002 May;50(5):740-1
11950827
Am J Gastroenterol. 2004 May;99(5):958
15128372
Gastroenterology. 2006 Dec;131(6):1981-2002
17087937
Histopathology. 2011 Aug;59(2):166-79
21054494
Dig Dis Sci. 2011 Jul;56(7):2042-9
21221796
Eur J Immunol. 1989 Jul;19(7):1335-8
2527159
Gut. 1992 Jun;33(6):767-72
1624157
Pediatrics. 2005 May;115(5):1341-6
15867045