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Published on: September 16, 2012
Phenotyping of peripheral blood lymphocytes in adult coeliac disease
A Di Sabatino1, E Bertrandi, M Casadei Maldini
1Department of Internal Medicine, University of L'Aquila, L'Aquila, Italy.
Insights
Peripheral blood lymphocyte counts are altered in coeliac disease, with decreases in certain cell types and signs of T-cell activation in untreated patients. These changes may relate to disease mechanisms and increased risks of malignancy.
Area of Science:
- Immunology
- Gastroenterology
- Cell Biology
Background:
- Coeliac disease involves immunological abnormalities beyond the small intestine.
- Peripheral blood lymphocyte changes may indicate predisposition to autoimmune or malignant complications.
Purpose of the Study:
- To analyze peripheral blood lymphocyte phenotypes in untreated coeliac patients, treated coeliac patients, and healthy volunteers.
- To investigate potential correlations between lymphocyte subset alterations and coeliac disease status.
Main Methods:
- Utilized dual-colour immunofluorescence and multiparameter flow cytometry.
- Analyzed absolute numbers and proportions of lymphocyte subsets (CD3+, CD4+, CD8+, CD19+, CD25+, HLA-DR+, FcepsilonR+, natural killer cells, cytotoxic cells).
Main Results:
- Untreated coeliacs showed decreased absolute counts of CD3+, CD4+, CD8+, and CD19+ lymphocytes compared to controls.
- Higher proportions of activated T-cells (CD3+ CD25+, CD3+ HLA-DR+) were observed in both untreated and treated coeliacs.
- Natural killer cells and cytotoxic cells were reduced in coeliac patients, while FcepsilonR+ B cells increased in untreated individuals.
Conclusions:
- Absolute lymphocyte reduction in coeliac disease likely reflects compartmentalization within the intestinal mucosa.
- Decreased natural killer and cytotoxic cells may correlate with the increased malignancy risk in coeliac disease.
- Observed phenotypic changes indicate T-cell activation in untreated coeliac disease.
Abstract:
In coeliac disease immunological abnormalities are not confined to the small bowel and it has been suggested that changes in peripheral blood lymphocytes may predispose to autoimmune or malignant complications. Using dual-colour immunofluorescence with labelled monoclonal antibodies, multiparameter flow cytometry was used to analyse peripheral blood lymphocytes in 32 untreated coeliacs, 29 treated coeliacs and 20 healthy volunteers. When the absolute numbers were considered, a decrease of CD3+, CD4+, CD8+ and CD19+ lymphocytes was found in untreated coeliacs compared with treated coeliacs and healthy volunteers. The proportion of CD3+ was significantly higher in untreated coeliacs (P<0.05) than in healthy volunteers. No differences were observed in CD4+, CD8+ and CD19+ subsets between the three groups studied. The proportion of CD3+ CD25+ and CD3+ HLA-DR+ cells were higher in untreated coeliacs (P<0. 001 and P>0.005) and in treated coeliacs (P<0.005 and P<0.05) than in healthy volunteers. On the contrary, natural killer cells and cytotoxic cells were lower in untreated and treated coeliacs than in healthy volunteers. As regards B-cell subsets, the only difference was the increase in FcepsilonR+ B cells in untreated coeliacs. The absolute reduction of peripheral lymphocytes in coeliac disease probably reflects their compartimentalization in intestinal mucosa. The decrease of natural killer cells and cytotoxic cells may be in keeping with the increased prevalence of malignancy in this condition. Finally, the phenotypic changes found in untreated coeliacs indicate T-cell activation.
