STUDIES OF INTESTINAL LYMPHOID-TISSUE .12. EPITHELIAL LYMPHOCYTE AND MUCOSAL RESPONSES TO RECTAL GLUTEN CHALLENGE IN CELIAC SPRUE
STUDIES OF INTESTINAL LYMPHOID-TISSUE .12. EPITHELIAL LYMPHOCYTE AND MUCOSAL RESPONSES TO RECTAL GLUTEN CHALLENGE IN CELIAC SPRUE
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DOI：
10.1016/0016-5085(89)91411-x
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发表时间：
1989-07-01
期刊：
影响因子：
29.4
通讯作者：
BAKER, R
中科院分区：
文献类型：
--
作者：
LOFT, DE;MARSH, MN;BAKER, R
已知的腹腔炎受试者的直肠粘膜免疫病理、结构和功能的改变在用面筋的消化-胰酶消化的局部攻击过程中被定量。在服用2g消化液的腹水患者中，主要作用发生在固有层、粘膜下层和局部微血管。固有层肿胀呈双相，从激发后1-2小时开始，纤维蛋白原在血管外广泛沉积，表明微血管通透性增加，在激发后24小时消退。肥大细胞的迅速减少和颗粒分泌表明它们参与了这一反应。晚期肿胀(48~72 h)前有大量中性粒细胞和嗜碱性粒细胞迅速涌入，72 h后可见脱颗粒。血管腔重建、肥大细胞增多和中性粒细胞丢失提示96 h时炎症细胞级联逐渐减弱。淋巴细胞在激发后2 h首次进入板层，逐渐增加，导致36~96 h大量浸润。上皮淋巴细胞显著增加，6~8 h达到最大值，24 h逐渐减弱。表面和隐窝上皮体积始终保持不变。在另一组4g面筋消化的挑战中，直肠黏膜的电位差在激发后12h显著降低，但净钠和氯离子吸收通量的相关下降并不显著。结论：直肠黏膜是乳糜泻的致敏谷蛋白，为研究和诊断提供了一种有前景的、方便的体内底物。
The immunopathologic, structural, and functional changes within rectal mucosa of known celiac sprue subjects were quantitated during local challenge with a peptic-tryptic digest of gluten. In the celiac sprue patients challenged with 2 g of digest, major effects occurred in lamina propria, submucosa, and local microvasculature. The lamina propria swelling was biphasic, starting 1-2 h after challenge with widespread extravascular deposition of fibrinogen, indicative of increased microvascular permeability, receding by 24 h postchallenge. A rapid fall in mast cells together with granule discharge suggested their involvement in this response. The late-phase swelling (48-72 h) was preceded by a rapid influx of neutrophils and basophils, the latter showing evidence of degranulation beyond 72 h. Reestablishment of vessel lumina, a rise in mast cells, and loss of neutrophils indicated tapering of the inflammatory cellular cascade by 96 h. Lymphocytes, first seen to enter the lamina by 2 h postchallenge, increased progressively, thereby resulting in substantial infiltration between 36 and 96 h. A marked rise in epithelial lymphocytes, maximal at 6-8 h, waned by 24 h. Volumes of surface and crypt epithelium remained constant throughout. In another challenge series with 4 g of gluten digest, electrical potential difference across rectal mucosa decreased significantly 12 h postchallenge, but the associated decreases in net sodium and chloride absorptive fluxes were insignificant. It is concluded that rectal mucosa is sensitized gluten in celiac sprue disease and thus offers a promising and convenient in vivo substrate for investigative and diagnostic purposes.