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Isolation and Flow Cytometric Analysis of Human Endocervical Gamma Delta T Cells
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Gamma-Delta T Lymphocytes in the Diagnostic Approach of Coeliac Disease

Petula Nijeboer1, Tom van Gils1, Martine Reijm2

  • 1Departments of Gastroenterology and Hepatology, Coeliac Center Amsterdam.

Journal of Clinical Gastroenterology
|May 22, 2018
PubMed

Insights

A high percentage of CD3 T-cell receptor gamma-delta chain (TCRγδ) intraepithelial lymphocytes (IELs) can help diagnose celiac disease (CD). A cut-off of 14% CD3TCRγδ IEL shows high specificity for CD diagnosis.

Area of Science:

  • Gastroenterology
  • Immunology
  • Diagnostic Pathology

Background:

  • Celiac disease (CD) is associated with an increased presence of gamma-delta intraepithelial lymphocytes (IELs).
  • CD3 T-cell receptor gamma-delta chain (TCRγδ) IELs are a specific type of IEL implicated in CD pathogenesis.

Purpose of the Study:

  • To establish and validate cut-off values for CD3TCRγδ IEL percentages in diagnosing celiac disease.
  • To assess the utility of CD3TCRγδ IEL quantification in differentiating CD from controls and potential CD cases.

Main Methods:

  • Flow cytometric analysis of IELs from small bowel biopsies.
  • Inclusion of 213 CD patients, 13 potential CD patients, and 112 controls.
  • Receiver operating characteristic (ROC) curve analysis to determine optimal cut-off values.

Main Results:

  • A significant increase in CD3TCRγδ IEL percentage was observed in most CD patients, regardless of villous atrophy.
  • A cut-off value of 14% for CD3TCRγδ IEL demonstrated 66.3% sensitivity and 96.6% specificity for CD.
  • The area under the ROC curve was 88.6%, indicating good diagnostic accuracy.

Conclusions:

  • A CD3TCRγδ IEL percentage of 14% or higher exhibits high specificity for celiac disease diagnosis.
  • This biomarker can aid in diagnosing CD, particularly in complex or ambiguous cases.
  • Quantification of CD3TCRγδ IELs offers a valuable tool in the differential diagnosis of celiac disease.
Abstract

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