- Title
- Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
- Creator
- Rostami, Kamran; Ensari, Arzu; Bell, Phoenix; Di Bella, Camillo; Bozzola, Anna Maria; Cadei, Moris; Casella, Giovanni; Catassi, Carlo; Ciacci, Carolina; Apostol Ciobanu, Delia Gabriela; Cross, Simon S.; Danciu, Mihai; Marsh, Michael N.; Das, P; Del Sordo, R; Drage, M; Elli, L; Fasano, A; Florena, AM; Fusco, N; Going, JJ; Guandalini, S; Hagen, CE; Srivastava, Amitabh; Hayman, DTS; Ishaq, S; Jericho, H; Johncilla, M; Johnson, M; Kaukinen, K; Levene, A; Liptrot, S; Lu, L; Makharia, GK; Villanacci, Vincenzo; Mathews, S; Mazzarella, G; Maxim, R; La Win Myint, K; Mohaghegh-Shalmani, H; Moradi, A; Mulder, CJJ; Ray, R; Ricci, C; Rostami-Nejad, M; Carroccio, Antonio; Sapone, A; Sanders, DS; Taavela, J; Volta, U; Walker, Marjorie; Derakhshan, M; Asadzadeh Aghdaei, Hamid; Bai, Julio C.; Bassotti, Gabrio; Becheanu, Gabriel
- Relation
- Nutrients Vol. 14, Issue 12, no. 2487
- Publisher Link
- http://dx.doi.org/10.3390/nu14122487
- Publisher
- Dove Medical Press Ltd.
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined. Villus height (VH, in μm), crypt depth (CrD, in μm), villus-to-crypt ratios (VCR), IELs (intraepithelial lymphocytes/100 enterocytes), and other relevant histological, serologic, and demographic parameters were quantified. Results: The median VH in NCGS was significantly shorter (600, IQR: 400−705) than controls (900, IQR: 667−1112) (p < 0.001). NCGS patients with Marsh I-II had similar VH and VCR to CeD [465 µm (IQR: 390−620) vs. 427 µm (IQR: 348−569, p = 0·176)]. The VCR in NCGS with Marsh 0 was lower than controls (p < 0.001). The median IEL in NCGS with Marsh 0 was higher than controls (23.0 vs. 13.7, p < 0.001). To distinguish Marsh 0 NCGS from controls, an IEL cut-off of 14 showed 79% sensitivity and 55% specificity. IEL densities in Marsh I-II NCGS and CeD groups were similar. Conclusion: NCGS duodenal mucosa exhibits distinctive changes consistent with an intestinal response to luminal antigens, even at the Marsh 0 stage of villus architecture.
- Subject
- non-coeliac gluten sensitivity; histology; normal mucosa; coeliac disease
- Identifier
- http://hdl.handle.net/1959.13/1486507
- Identifier
- uon:51872
- Identifier
- ISSN:1179-1594
- Language
- eng
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