Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Controlled Clinical Trial
. 2016 Aug 26;8(9):525.
doi: 10.3390/nu8090525.

Persistent Intraepithelial Lymphocytosis in Celiac Patients Adhering to Gluten-Free Diet Is Not Abolished Despite a Gluten Contamination Elimination Diet

Barbara Zanini  1 , Monica Marullo  2 , Vincenzo Villanacci  3 , Marianna Salemme  4 , Francesco Lanzarotto  5 , Chiara Ricci  6 , Alberto Lanzini  7
Affiliations
Controlled Clinical Trial

Persistent Intraepithelial Lymphocytosis in Celiac Patients Adhering to Gluten-Free Diet Is Not Abolished Despite a Gluten Contamination Elimination Diet

Barbara Zanini et al. Nutrients. .

Abstract

The gluten-free diet (GFD) is the only validated treatment for celiac disease (CD), but despite strict adherence, complete mucosal recovery is rarely obtained. The aim of our study was to assess whether complete restitutio ad integrum could be achieved by adopting a restrictive diet (Gluten Contamination Elimination Diet, GCED) or may depend on time of exposure to GFD. Two cohorts of CD patients, with persisting Marsh II/Grade A lesion at duodenal biopsy after 12-18 months of GFD (early control) were identified. Patients in Cohort A were re-biopsied after a three-month GCED (GCED control) and patients in Cohort B were re-biopsied after a minimum of two years on a standard GFD subsequent to early control (late control). Ten patients in Cohort A and 19 in Cohort B completed the study protocol. There was no change in the classification of duodenal biopsies in both cohorts. The number of intraepithelial lymphocytes, TCRγδ+ (T-Cell Receptor gamma delta) T cell and eosinophils significantly decreased at GCED control (Cohort A) and at late control (Cohort B), compared to early control. Duodenal intraepithelial lymphocytosis persisting in CD patients during GFD is not eliminated by a GCED and is independent of the length of GFD. [NCT 02711696].

Keywords: celiac disease; gluten contamination; gluten free diet; mucosal recovery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design flow-chart and patients assignment in the two cohorts.
Figure 2
Figure 2
Histologic Changes at the time of diagnosis, at early control and during Gluten Elimination Contamination Diet (GCED) in the number of: IntraEpithelial Lymphocytes (IEL) (a); gamma-delta CD3 (b); and eosinophils (c).
Figure 3
Figure 3
Histologic Changes at the time of diagnosis, at early and late control during Gluten Free Diet (GFD) in the number of: IntraEpithelial Lymphocytes (IEL (a); gamma-delta CD3 (b); and eosinophils (c).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Marsh M.N. Gluten, major histocompatibility complex and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity (celiac sprue) Gastroenterology. 1992;102:330–354. doi: 10.1016/0016-5085(92)91819-P. - DOI - PubMed
    1. Oberhuber G., Granditsch G., Volgelsang H. The histopathology of celiac disease: Time for a standardized report scheme for pathologists. Eur. J. Gastroenterol. Hepatol. 1999;11:1185–1194. doi: 10.1097/00042737-199910000-00019. - DOI - PubMed
    1. Corazza G.R., Villanacci V. Coeliac Disease. Some considerations on the histological classification. J. Clin. Pathol. 2005;58:573–574. doi: 10.1136/jcp.2004.023978. - DOI - PMC - PubMed
    1. Corazza G.R., Villanacci V., Zambelli C., Milione M., Luinetti O., Vindigni C., Chioda C., Albarello L., Bartolini D., Donato F. Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease. Clin. Gastroenterol. Hepatol. 2007;5:838–843. doi: 10.1016/j.cgh.2007.03.019. - DOI - PubMed
    1. Villanacci V., Ceppa P., Tavani E., Vindigni C., Volta U., Gruppo Italiano Patologi Apparato Digerente (GIPAD) Società Italiana di Anatomia Patologica e Citopatologia Diagnostica/International Academy of Pathology, Italian division (SIAPEC/IAP) Coeliac disease: The histology report. Dig. Liver. Dis. 2011;43:S385–S395. doi: 10.1016/S1590-8658(11)60594-X. - DOI - PubMed

Publication types

LinkOut - more resources