Impaired lymphocyte reactivity against tumour cells in patients with coeliac disease

The lymphocytes of patients with coeliac disease are shown to have a significant diminution of proliferative and cytotoxic capacity as compared to normal lymphocytes when challenged in vitro with tumour cells from a lymphoma cell line. This impaired responsiveness is partly related to an intrinsic cellular defect but an inhibiting factor in the serum of coeliac patients has also been demonstrated. The impaired coeliac lymphocyte response in this in-vitro test system may serve as an indicator of a comparable defect in immune surveillance in vivo. This would account for the increased incidence of lymphosarcoma known to arise in patients with longstanding coeliac disease and might also explain the raised incidence of other gut-related tumours in these patients.