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Updated: Mar 14, 2026
Intravital Imaging of Intraepithelial Lymphocytes in Murine Small Intestine
Published on: June 24, 2019
Intraepithelial lymphocytes subsets in different forms of celiac disease
M Sánchez-Castañon1, B G Castro2, M Toca1
1Immunology Section, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008, Santander, Spain.
Insights
Flow cytometry quantification of intraepithelial lymphocytes (IELs) aids celiac disease diagnosis. This IEL lymphogram effectively differentiates active and silent celiac disease in patients.
Area of Science:
- Immunology
- Gastroenterology
- Diagnostic Medicine
Background:
- Intraepithelial lymphocytes (IELs) play a role in mucosal immunity.
- Flow cytometry (FCM) is a method for enumerating cell populations.
- Celiac disease (CD) diagnosis relies on specific immunological markers.
Purpose of the Study:
- To quantify IEL subsets (total, γδ, CD3(-)) using FCM.
- To evaluate the diagnostic value of IEL lymphograms for celiac disease.
- To differentiate between active, silent, and potential CD.
Main Methods:
- Prospective study involving 60 active CD patients, 20 silent CD patients, and 161 controls.
- Duodenal biopsies were obtained for analysis.
- IELs were quantified using FCM to generate an IEL lymphogram.
Main Results:
- Active and silent CD patients showed significantly higher total and γδ IELs compared to controls.
- Active and silent CD patients had significantly lower CD3(-) IELs than controls.
- IEL subset changes were more pronounced in children with active CD.
Conclusions:
- FCM-based IEL subset evaluation is a valuable tool for confirming active and silent CD diagnoses.
- The IEL lymphogram provides distinct quantitative measures for CD subtyping.
- Specific cut-off values for IEL subsets can aid in diagnosing active and silent CD.
Aim:
The enumeration of intraepithelial lymphocytes subsets (total, γδ, and CD3(-) IELs) by flow cytometry (FCM), named as IEL lymphogram, constitutes a useful tool for celiac disease (CD) diagnosis. The aim of this study was to quantify IELs by FCM and their diagnostic value to differentiate active, silent and potential CD.
Methods:
Prospective study of 60 active and 20 silent CD patients, and 161 controls in which duodenal biopsy and IEL quantification by FCM was performed.
Results:
Active and silent CD patients had significant higher levels of both total and γδ IELs than absent CD patients (P < 0.0001 and P < 0.0001, P = 0.012 and P < 0.011; respectively). Active and silent CD patients had significant lower levels of CD3(-) IELs than absent CD patients (P < 0.047 and P < 0.009, respectively). Moreover, they were lower in silent than in active CD patients (P = 0.002). Changes of IELs subsets were more marked in children than adults active CD. The optimal IEL lymphogram cut off values for active CD diagnosis were: ≥10, ≥15 and ≤9 %, and with better performance characteristics for silent CD: ≥ 11, ≥10 and ≤5 %.
Conclusion:
The evaluation of IELs subsets by FCM is useful to confirm diagnosis of active and silent CD.
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