Gluten induces subtle histological changes in duodenal mucosa of patients with non-coeliac gluten sensitivity: A multicentre study Journal Article
| Authors: | Rostami, K.; Ensari, A.; Marsh, M. N.; Srivastava, A.; Villanacci, V.; Carroccio, A.; Aghdaei, H. A.; Bai, J. C.; Bassotti, G.; Becheanu, G.; Bell, P.; Di Bella, C.; Bozzola, A. M.; Cadei, M.; Casella, G.; Catassi, C.; Ciacci, C.; Ciobanu, D. G. A.; Cross, S. S.; Danciu, M.; Das, P.; Del Sordo, R.; Drage, M.; Elli, L.; Fasano, A.; Florena, A. M.; Fusco, N.; Going, J. J.; Guandalini, S.; Hagen, C. E.; Hayman, D. T. S.; Ishaq, S.; Jericho, H.; Johncilla, M.; Johnson, M.; Kaukinen, K.; Levene, A.; Liptrot, S.; Lu, L.; Makharia, G. K.; Mathews, S.; Mazzarella, G.; Maxim, R.; Myint, K. L. W.; Mohaghegh-Shalmani, H.; Moradi, A.; Mulder, C. J. J.; Ray, R.; Ricci, C.; Rostami-Nejad, M.; Sapone, A.; Sanders, D. S.; Taavela, J.; Volta, U.; Walker, M.; Derakhshan, M. |
| Article Title: | Gluten induces subtle histological changes in duodenal mucosa of patients with non-coeliac gluten sensitivity: A multicentre study |
| Abstract: | 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. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. |
| Keywords: | adult; controlled study; human tissue; human cell; major clinical study; clinical trial; comparative study; sensitivity and specificity; pathology; biopsy; histology; medical information; quantitative analysis; multicenter study; cross-sectional study; endoscopic biopsy; double blind procedure; duodenum; intestine cell; lymphocyte count; intestine mucosa; interrater reliability; eosinophil count; intestinal mucosa; celiac disease; gluten free diet; lamina propria; gluten; humans; human; male; female; article; normal mucosa; coeliac disease; non-coeliac gluten sensitivity; duodenum mucosa; intraepithelial lymphocyte; non-celiac gluten sensitivity; wheat allergy; diet, gluten-free; glutens |
| Journal Title: | Nutrients |
| Volume: | 14 |
| Issue: | 12 |
| ISSN: | 2072-6643 |
| Publisher: | MPDI AG |
| Date Published: | 2022-06-02 |
| Start Page: | 2487 |
| Language: | English |
| DOI: | 10.3390/nu14122487 |
| PUBMED: | 35745217 |
| PROVIDER: | scopus |
| PMCID: | PMC9230100 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2022 -- Source: Scopus |
