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Duodenal mast cells and eosinophils in children with celiac disease: occurrence and distribution pattern
Marie Struffert1, Christoph Maier1, Matthias Neid2
1Department of Pediatric Gastroenterology, St. Josef-Hospital, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University, Bochum, Germany.
Insights
Celiac disease patients show increased duodenal mast cells (MC) and eosinophils (EO) compared to controls. MC distribution differs in the lamina propria, suggesting both cell types contribute to celiac disease pathogenesis.
Area of Science:
- Gastroenterology
- Immunology
- Pediatric Pathology
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- Mast cells (MC) and eosinophils (EO) are immune cells implicated in inflammatory conditions.
- Understanding their role in pediatric celiac disease is crucial for pathogenesis insights.
Purpose of the Study:
- To quantify duodenal mast cell (MC) and eosinophil (EO) numbers in pediatric celiac disease patients.
- To analyze the distribution of MC and EO within the duodenal lamina propria.
- To investigate the potential impact of these cells on celiac disease severity.
Main Methods:
- Analysis of duodenal biopsies from 215 children (109 CD, 106 controls) undergoing endoscopy.
- Immunohistochemical staining to identify and quantify MC and EO in high-power fields.
- Assessment of cell distribution within the lamina propria and correlation with clinical parameters.
Main Results:
- Increased MC density (p=0.008) and eosinophils (p<0.001) in the duodenum of celiac patients compared to controls.
- Mast cells exhibited a more homogeneous distribution throughout the lamina propria in CD patients.
- No significant association found between elevated EO counts and atopic diseases.
Conclusions:
- Duodenal mast cell and eosinophil numbers are elevated in pediatric celiac disease.
- Mast cell distribution patterns differ significantly between celiac and non-celiac children.
- These findings support the involvement of MC and EO in celiac disease pathogenesis, warranting further functional studies.
Objective:
The aim of this study was to characterize duodenal mast cell (MC) and eosinophil (EO) numbers, their distribution within the lamina propria and possible impact on disease severity of paediatric celiac patients compared to children without celiac disease (CD).
Methods:
We analysed duodenal samples of 215 children (109 CD, 106 controls) who underwent esophagogastroduodenoscopy from 2010 to 2018. After immunohistochemical staining, average MC and EO counts were histologically examined in ten high-power-fields. Additionally, cell-distribution within the lamina propria was analysed. Possible influence of relevant clinical parameters was evaluated.
Statistics:
Student's-t-test, Mann-Whitney U-test, Chi-square-test, ANOVA, significance-level <.05. Trial registration-number: DRKS00024669.
Results:
MC-density was higher in CD-patients compared to the control-group (23.7 (±12.1)/HPF versus 19.7 (±9.1)/HPF; p = .008), varying in number interindividually. Eosinophils were also increased in the duodenum of celiac patients (23.3 (±9.3)/HPF versus 12.2 (±6.3)/HPF; p= <.001). MCs were distributed more often homogenously in all parts of CD lamina propria (44 biopsies (40.4%), residing more distant from the intestinal lumen in controls (0 biopsies with homogenous distribution-pattern (0%); p= <.001). Regarding EOs no polarity was observable. Atopic diseases did not occur significantly more often in patients with elevated EO-counts.
Conclusion:
MC- and EO-numbers were increased in the duodenum of CD-patients and MCs showed a different distribution-pattern in the lamina propria of celiac patients. These findings support the concept that both cell-types contribute to disease-pathogenesis. However, functional studies highlighting both cell-types' and their mediators' role regarding mucosal alterations during the course of the inflammatory process in celiac patients are needed.
Trial Registration Number And Url:
DRKS00024669; https://www.drks.de/drks_web/.
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