Alpha-1-antitrypsin immunoreactivity in the small bowel in coeliac disease

The role of alpha-1-antitrypsin (A1AT) in the small intestinal mucosa in health and disease is poorly understood. We studied the prevalence and distribution of A1AT positive cells in small bowel biopsies from 35 coeliac disease patients and 25 normal controls retrieved from the records of the Department of Pathology, University of Oxford. Serial 6 micron thick paraffin sections were stained with H&E, PAS, PAS-diastase and for A1AT employing an indirect immunoperoxidase technique. None of these cases had biochemical evidence of A1AT deficiency. In the present study, 24 out of 35 small bowel biopsies among coeliacs (68.5%) compared to 13 out of normal controls (52%) showed A1AT immunoreactivity. Thus our findings point to the preservation of A1AT in coeliac disease.