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Intravital Imaging of Intraepithelial Lymphocytes in Murine Small Intestine
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Cell Density Counts of the Intestinal Intraepithelial Lymphocytes in the Celiac Patients

Hadi Hossein-Nataj1, Mohsen Masjedi, Mohammad Hassan Emami

  • 1Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran.

Iranian Journal of Immunology : IJI
|June 12, 2019
PubMed

Insights

In celiac disease (CD) diagnosis, CD8+ intraepithelial lymphocytes (IELs) T-cells may show borderline values even with normal total IELs counts. These findings aid in diagnosing CD and guiding gluten-free diet decisions.

Area of Science:

  • Gastroenterology
  • Immunology
  • Histopathology

Background:

  • Increased intestinal intraepithelial lymphocytes (IELs) are key in celiac disease (CD) diagnosis.
  • IEL counts vary regionally, and some seronegative CD patients have borderline histology.

Purpose of the Study:

  • To determine CD3+ and CD8+ IEL T-cell counts in celiac patients and healthy controls in Isfahan.
  • Establish upper normal limits for IELs in this population.

Main Methods:

  • Duodenal biopsies analyzed from 15 CD patients and 19 controls.
  • Total IELs counted via H&E staining; CD3+ and CD8+ IELs via immunohistochemistry (IHC).

Main Results:

  • Upper normal limits established: total IELs (37), CD3+ IELs (22), CD8+ IELs (12) per 100 epithelial cells (ECs).
  • Three clinically diagnosed CD patients had IEL counts below normal limits with negative serology/histology, but borderline CD8+ IELs.
  • These patients responded positively to a gluten-free diet (GFD).

Conclusions:

  • CD8+ IEL T-cell counts can be a valuable diagnostic parameter in celiac disease.
  • Borderline CD8+ IEL counts, alongside negative assays, can support CD diagnosis and GFD initiation.
Abstract

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