HLA-DP and coeliac disease: family and population studies
Article Abstract:
Celiac disease (CD) is an intestinal malabsorption syndrome in which diarrhea, malnutrition, and bleeding are common. CD is reversed by removal of gluten-containing cereals from the diet. CD has a genetic component that has been associated with several histocompatibility antigens. These are specific proteins present on most cells in the body. Their presence is controlled by genes that code for them, and they recognize 'self' tissues for the immune system. Thus, transplantation of foreign tissue presents new antigens to the immune system, and antibodies against the new antigens are promptly made. Human antigens are called human leukocyte (white blood cell) antigens (HLA) and different HLA subsets are associated with the occurrence of many diseases. The relationship between the subclass HLA (class II), HLA-DP, and coeliac disease, as well as the association with insulin-dependent diabetes mellitus (IDDM) and dermatitis herpetiformis (DH, another gluten-related disease), was studied in 254 subjects with these diseases or who were in a family with CD. The results confirmed previous studies which showed that people with CD frequently had an alteration in the alpha portion of the HLA-DP structure. Further, people with DH also tended to have this alteration, although less often, while people with IDDM and healthy subjects did not. An additional alteration in the beta portion of HLA-DP was found in people with CD; many of the CD patients with the alpha alteration had the beta alteration. Alterations in HLA-DP alpha structure were not associated with particular forms of two other class II HLA proteins, HLA-DR and HLA-DQ. Further, some CD patients did not possess the HLA-DP alpha alteration. The study indicates that susceptibility to CD may be related to more than one HLA characteristic, or to a complex mixture of HLA factors. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1990
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Increase in gamma/delta T cell receptor bearing lymphocytes in normal small bowel mucosa in latent coeliac disease
Article Abstract:
Celiac disease is an intestinal malabsorption syndrome characterized by intestinal bleeding, diarrhea, malnutrition, and disordered calcium metabolism. This condition is caused, at least in part, by a hypersensitivity to dietary gluten (a protein found in wheat). Celiac disease has been reported to have a higher prevalence and to occur in a latent form in patients with herpetiform dermatitis (an inflammatory disease of the skin); both of these conditions have been linked to disorders of the immune system. It has been reported that increased levels of a particular subclass of immune cell (T lymphocytes which express the gamma/delta receptor molecule) may be a diagnostic marker for the presence of both latent and overt celiac disease. A case (the first such documented case) is described of a 35-year-old man who was studied because of an abnormality in blood chemistry (low serum titer of reticulin antibody) and because of the presence of overt celiac disease in his son. (The patient had been diagnosed with epilepsy, and suffered infrequent seizures; this was not thought to be related to the variables assessed in this case.) Intestinal biopsy revealed completely normal anatomy of the small intestine, and celiac disease would have been ruled out on this basis alone. Total lymphocyte level was normal in the biopsy specimen, but the number of cells expressing the gamma/delta T cell receptor was 10 times that found in normal subjects. Two years later, a subsequent intestinal biopsy specimen was taken because of celiac disease symptom onset; microscopic anatomy was consistent with a diagnosis of celiac disease. A biopsy taken during a period in which the patient was on a gluten-free diet showed normal intestinal anatomy, but continued elevation of gamma/delta T cell receptor-positive lymphocytes. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1991
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Jejunal immunoglobulin and antigliadin antibody secretion in adult coeliac disease
Article Abstract:
Celiac disease is an inflammatory disorder of the small intestine (jejunum) characterized by malabsorption of nutrients, diarrhea, malnutrition, and intestinal bleeding. The mechanisms underlying this disease are not known, but it is thought that an imbalance in the immune system of the gastrointestinal mucosa may play an important role. Investigation of the mucosal immune system requires either biopsy samples or perfusion of the afflicted intestinal segments with non-absorbed fluids that are retrieved and analyzed. The former procedure is unpleasant, invasive, and dangerous to the patient, while the latter often yields contaminated samples that do not give unequivocal results. To investigate the levels of specific antibodies in the jejunum of patients with Celiac disease and in healthy volunteers, a novel technique was employed for perfusing limited segments of the jejunum with a multibarreled perfusion catheter system. Six adult patients with Celiac disease and nine healthy volunteers underwent intestinal perfusion with this technique. The perfusate collected from the patients, when compared with the controls, showed a two and five-fold increase in the levels of immunoglobulin A (IgA) and immunoglobulin M (IgM), two products of the immune system that can act as antibodies. The increases were paralleled by increases in the cell types from which these immunoglobulins are secreted. There were no changes in jejunal levels of immunoglobulin G (IgG). Antigliadin IgA (an antibody against gliadin, a protein found in wheat and gluten) was increased in both the jejunum and serum of Celiac disease patients. However, the serum antibody may have a different origin than the jejunal antibody. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Gut
Subject: Health
ISSN: 0017-5749
Year: 1990
User Contributions:
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