Nutrients (Jun 2022)
Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
- Kamran Rostami,
- Arzu Ensari,
- Michael N. Marsh,
- Amitabh Srivastava,
- Vincenzo Villanacci,
- Antonio Carroccio,
- Hamid Asadzadeh Aghdaei,
- Julio C. Bai,
- Gabrio Bassotti,
- Gabriel Becheanu,
- Phoenix Bell,
- Camillo Di Bella,
- Anna Maria Bozzola,
- Moris Cadei,
- Giovanni Casella,
- Carlo Catassi,
- Carolina Ciacci,
- Delia Gabriela Apostol Ciobanu,
- Simon S. Cross,
- Mihai Danciu,
- Prasenjit Das,
- Rachele Del Sordo,
- Michael Drage,
- Luca Elli,
- Alessio Fasano,
- Ada Maria Florena,
- Nicola Fusco,
- James J. Going,
- Stefano Guandalini,
- Catherine E. Hagen,
- David T. S. Hayman,
- Sauid Ishaq,
- Hilary Jericho,
- Melanie Johncilla,
- Matt Johnson,
- Katri Kaukinen,
- Adam Levene,
- Sarah Liptrot,
- Laura Lu,
- Govind K. Makharia,
- Sherly Mathews,
- Giuseppe Mazzarella,
- Roxana Maxim,
- Khun La Win Myint,
- Hamid Mohaghegh-Shalmani,
- Afshin Moradi,
- Chris J. J. Mulder,
- Ronnie Ray,
- Chiara Ricci,
- Mohammad Rostami-Nejad,
- Anna Sapone,
- David S. Sanders,
- Juha Taavela,
- Umberto Volta,
- Marjorie Walker,
- Mohammad Derakhshan
Affiliations
- Kamran Rostami
- Department of Gastroenterology, Palmerston North District Health Board (DHB), Palmerston North 4442, New Zealand
- Arzu Ensari
- Department of Pathology, Ankara University Medical School, Ankara 06620, Turkey
- Michael N. Marsh
- Oxford & Department of Gastroenterology, Wolfson College, University of Oxford, Luton & Dunstable University Hospital Trust, Bedfordshire LU4 0DZ, UK
- Amitabh Srivastava
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Vincenzo Villanacci
- Spedali Civili, Institute of Pathology, 25100 Brescia, Italy
- Antonio Carroccio
- Palermo, Internal Medicine Unit, Department ‘PROMISE’, University of Palermo, “V. Cervello Hospital”, 90100 Palermo, Italy
- Hamid Asadzadeh Aghdaei
- Gastroenterology and Liver Diseases Reseach Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
- Julio C. Bai
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
- Gabrio Bassotti
- Department of Medicine, University of Perugia School of Medicine, 06129 Perugia, Italy
- Gabriel Becheanu
- Department of Pathology, Carol Davila University of Medicine & Pharmacy, 050474 Bucharest, Romania
- Phoenix Bell
- Gastrointestinal Pathology Center of Excellence University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
- Camillo Di Bella
- Department of Pathology, University of Milan-Bicocca, 20900 Monza, Italy
- Anna Maria Bozzola
- Spedali Civili, Institute of Pathology, 25100 Brescia, Italy
- Moris Cadei
- Spedali Civili, Institute of Pathology, 25100 Brescia, Italy
- Giovanni Casella
- Medical Deptartment, Desio Hospital, 20832 Desio, Italy
- Carlo Catassi
- Deptartment of Pediatrics, Universita Politecnica delle Marche, 60123 Ancona, Italy
- Carolina Ciacci
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Scuola Medica Salernitana, Università di Salerno Gastroenterologia, 84084 Salerno, Italy
- Delia Gabriela Apostol Ciobanu
- Pathology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Simon S. Cross
- Gastroenterology and Pathology, Sheffield Teaching Hospitals, Sheffield S10 2JF, UK
- Mihai Danciu
- Pathology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Prasenjit Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
- Rachele Del Sordo
- Department of Experimental Medicine, Section of Anatomic Pathology and Histology, Medical School, University of Perugia, 06125 Perugia, Italy
- Michael Drage
- Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY 14607, USA
- Luca Elli
- Center for Prevention and Diagnosis of Coeliac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Alessio Fasano
- Massachusetts General Hospital, Center for Celiac Research & Treatment, Boston, MA 02114, USA
- Ada Maria Florena
- Anatomic Pathology Unit, Department ‘PROMISE’, Palermo, University of Palermo, A.O.U. Policlinico “P. Giaccone”, 17491 Palermo, Italy
- Nicola Fusco
- Division of Pathology, Fondazione IRCSS Ca’ Granda-Ospedale Maggiore Policlinico, University of Milan, 20832 Milan, Italy
- James J. Going
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
- Stefano Guandalini
- Department of Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
- Catherine E. Hagen
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN 55907, USA
- David T. S. Hayman
- Molecular Epidemiology & Public Health Laboratory, School of Veterinary Science, Massey University, Palmerston North 4472, New Zealand
- Sauid Ishaq
- Dudley Group NHS Foundation Trust, Birmingham City University, Birmingham B5 5JU, UK
- Hilary Jericho
- Department of Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
- Melanie Johncilla
- Weill Cornell Medicine, New York, NY 10075, USA
- Matt Johnson
- Luton Dunstable University Hospital, Gastroenterology, Luton LU4 0DZ, UK
- Katri Kaukinen
- Department of Internal Medicine, Tampere University Hospital, 33100 Tampere, Finland
- Adam Levene
- Luton Dunstable University Hospital, Gastroenterology, Luton LU4 0DZ, UK
- Sarah Liptrot
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
- Laura Lu
- Department of Histopathology, Royal Wolverhampton NHS Trust, Newcross Hospitals, Wolverhempton WV10 0QP, UK
- Govind K. Makharia
- Department of Gastroenterology, Human Nutrition, All India Institute of Medical Sciences, New Delhi 110029, India
- Sherly Mathews
- Haematology Unit, Milton Keynes University Hospital, Milton Keynes MK6 5LD, UK
- Giuseppe Mazzarella
- Institute of Food Sciences-CNR, Immuno-Morphology, 83100 Avellino, Italy
- Roxana Maxim
- Pathology Department, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Khun La Win Myint
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
- Hamid Mohaghegh-Shalmani
- Gastroenterology and Liver Diseases Reseach Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
- Afshin Moradi
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
- Chris J. J. Mulder
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
- Ronnie Ray
- Luton Dunstable University Hospital, Gastroenterology, Luton LU4 0DZ, UK
- Chiara Ricci
- Department of Experimental and Clinical Sciences, University of Brescia, 25100 Brescia, Italy
- Mohammad Rostami-Nejad
- Gastroenterology and Liver Diseases Reseach Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
- Anna Sapone
- Massachusetts General Hospital, Center for Celiac Research & Treatment, Boston, MA 02114, USA
- David S. Sanders
- Gastroenterology and Pathology, Sheffield Teaching Hospitals, Sheffield S10 2JF, UK
- Juha Taavela
- Central Finland Central Hospital, 33520 Jyväskylä, Finland
- Umberto Volta
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Marjorie Walker
- Department of Anatomical Pathology, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Mohammad Derakhshan
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
- DOI
- https://doi.org/10.3390/nu14122487
- Journal volume & issue
-
Vol. 14,
no. 12
p. 2487
Abstract
Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined. Villus height (VH, in μm), crypt depth (CrD, in μm), villus-to-crypt ratios (VCR), IELs (intraepithelial lymphocytes/100 enterocytes), and other relevant histological, serologic, and demographic parameters were quantified. Results: The median VH in NCGS was significantly shorter (600, IQR: 400–705) than controls (900, IQR: 667–1112) (p p = 0·176)]. The VCR in NCGS with Marsh 0 was lower than controls (p p Conclusion: NCGS duodenal mucosa exhibits distinctive changes consistent with an intestinal response to luminal antigens, even at the Marsh 0 stage of villus architecture.
Keywords
