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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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