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Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230100/ https://www.ncbi.nlm.nih.gov/pubmed/35745217 http://dx.doi.org/10.3390/nu14122487 |
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author | Rostami, Kamran Ensari, Arzu Marsh, Michael N. Srivastava, Amitabh Villanacci, Vincenzo Carroccio, Antonio Asadzadeh Aghdaei, Hamid Bai, Julio C. Bassotti, Gabrio Becheanu, Gabriel 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 Das, Prasenjit Del Sordo, Rachele Drage, Michael Elli, Luca Fasano, Alessio Florena, Ada Maria Fusco, Nicola Going, James J. Guandalini, Stefano Hagen, Catherine E. Hayman, David T. S. Ishaq, Sauid Jericho, Hilary Johncilla, Melanie Johnson, Matt Kaukinen, Katri Levene, Adam Liptrot, Sarah Lu, Laura Makharia, Govind K. Mathews, Sherly Mazzarella, Giuseppe Maxim, Roxana La Win Myint, Khun Mohaghegh-Shalmani, Hamid Moradi, Afshin Mulder, Chris J. J. Ray, Ronnie Ricci, Chiara Rostami-Nejad, Mohammad Sapone, Anna Sanders, David S. Taavela, Juha Volta, Umberto Walker, Marjorie Derakhshan, Mohammad |
author_facet | Rostami, Kamran Ensari, Arzu Marsh, Michael N. Srivastava, Amitabh Villanacci, Vincenzo Carroccio, Antonio Asadzadeh Aghdaei, Hamid Bai, Julio C. Bassotti, Gabrio Becheanu, Gabriel 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 Das, Prasenjit Del Sordo, Rachele Drage, Michael Elli, Luca Fasano, Alessio Florena, Ada Maria Fusco, Nicola Going, James J. Guandalini, Stefano Hagen, Catherine E. Hayman, David T. S. Ishaq, Sauid Jericho, Hilary Johncilla, Melanie Johnson, Matt Kaukinen, Katri Levene, Adam Liptrot, Sarah Lu, Laura Makharia, Govind K. Mathews, Sherly Mazzarella, Giuseppe Maxim, Roxana La Win Myint, Khun Mohaghegh-Shalmani, Hamid Moradi, Afshin Mulder, Chris J. J. Ray, Ronnie Ricci, Chiara Rostami-Nejad, Mohammad Sapone, Anna Sanders, David S. Taavela, Juha Volta, Umberto Walker, Marjorie Derakhshan, Mohammad |
author_sort | Rostami, Kamran |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-9230100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92301002022-06-25 Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study Rostami, Kamran Ensari, Arzu Marsh, Michael N. Srivastava, Amitabh Villanacci, Vincenzo Carroccio, Antonio Asadzadeh Aghdaei, Hamid Bai, Julio C. Bassotti, Gabrio Becheanu, Gabriel 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 Das, Prasenjit Del Sordo, Rachele Drage, Michael Elli, Luca Fasano, Alessio Florena, Ada Maria Fusco, Nicola Going, James J. Guandalini, Stefano Hagen, Catherine E. Hayman, David T. S. Ishaq, Sauid Jericho, Hilary Johncilla, Melanie Johnson, Matt Kaukinen, Katri Levene, Adam Liptrot, Sarah Lu, Laura Makharia, Govind K. Mathews, Sherly Mazzarella, Giuseppe Maxim, Roxana La Win Myint, Khun Mohaghegh-Shalmani, Hamid Moradi, Afshin Mulder, Chris J. J. Ray, Ronnie Ricci, Chiara Rostami-Nejad, Mohammad Sapone, Anna Sanders, David S. Taavela, Juha Volta, Umberto Walker, Marjorie Derakhshan, Mohammad Nutrients Article 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. MDPI 2022-06-15 /pmc/articles/PMC9230100/ /pubmed/35745217 http://dx.doi.org/10.3390/nu14122487 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rostami, Kamran Ensari, Arzu Marsh, Michael N. Srivastava, Amitabh Villanacci, Vincenzo Carroccio, Antonio Asadzadeh Aghdaei, Hamid Bai, Julio C. Bassotti, Gabrio Becheanu, Gabriel 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 Das, Prasenjit Del Sordo, Rachele Drage, Michael Elli, Luca Fasano, Alessio Florena, Ada Maria Fusco, Nicola Going, James J. Guandalini, Stefano Hagen, Catherine E. Hayman, David T. S. Ishaq, Sauid Jericho, Hilary Johncilla, Melanie Johnson, Matt Kaukinen, Katri Levene, Adam Liptrot, Sarah Lu, Laura Makharia, Govind K. Mathews, Sherly Mazzarella, Giuseppe Maxim, Roxana La Win Myint, Khun Mohaghegh-Shalmani, Hamid Moradi, Afshin Mulder, Chris J. J. Ray, Ronnie Ricci, Chiara Rostami-Nejad, Mohammad Sapone, Anna Sanders, David S. Taavela, Juha Volta, Umberto Walker, Marjorie Derakhshan, Mohammad Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title | Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title_full | Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title_fullStr | Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title_full_unstemmed | Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title_short | Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study |
title_sort | gluten induces subtle histological changes in duodenal mucosa of patients with non-coeliac gluten sensitivity: a multicentre study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230100/ https://www.ncbi.nlm.nih.gov/pubmed/35745217 http://dx.doi.org/10.3390/nu14122487 |
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