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Phenotyping of Intraepithelial Lymphocytes (IELs) Proves to be a Useful Test in Intestinal Pathology

Celiac.com 08/29/2007 - A study that appeared in the August issue of Journal of Clinical Gastroenterology, found that celiac disease and small intestinal bacterial growth both show increased levels of intraepithelial lymphocytes (IELs), especially gammadelta+ IELs. A sharp increase in gammadelta+ IELs has been noted in people with celiac disease, but little is known about the role of this particular class of IELs in other intestinal pathologies.

A team of researchers led by J.M. Remes-Troche set out to assess the levels of IEls, especially of gammadelta+, in the duodenal mucosa biopsies from individuals w/ celiac disease and to compare them with those of patients with small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS).

The study team looked at 12 individuals with untreated celiac disease, 8 patients with SIBO, and 10 patients with diarrhea-predominant IBS. All patients were given an upper-endoscopy for mucosal biopsy and jejunal aspirate. Intraepithelial cells were isolated from 2 small bowel biopsies, and labeled with monoclonal antibodies CD103-PE (phycoerythrin), CD3-FITC (fluoresecein isothio-cynate), CD-7R-PE, CD45RO-APC (allophycocyanin), and TcR gammadelta-FITC.

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Researchers conducted flow cytometry analysis using a standard FACScan. Total IEL levels and subsequent levels were catalogued as percentages as follows: 16.7 +/- 6% for IBS patients; 25.7 +/- 17% for SIBO patients; and 26 +/- +/- 13% in celiac patients (P=0.2). Patients with SIBO & celiac disease showed significantly higher percentages of gammadelta+ IELs (14.6 +/- 8% and 15.7 +/- 13%) compared to IBS patients (4.1 +/- 2.5%, P<0.05).

The results of the study indicate that gammadelta+ IELs might play a crucial role against intestinal bacterial infections.

Journal of Clinical Gastroenterology. 2007 Aug;41(7):671-676

health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

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sadaf
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26 Dec 2007 10:23:30 AM PDT
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There is also a celiac center at UCLA - Dr Weiss

mnburis, I'm concerned about your symptoms, especially the diarrhea being so frequent. I experienced pellagra after prolonged diarrhea. The symptoms are diarrhea, dermatitis, dementia and death. Pellagra is a deficiency of niacin (B 3). With your vitamin D and B 12 already diagnosed as ...

thats so exciting! let me know if you need any help with finding gluten-free products or brands when you move here

I have had NO breath tests done. Just blood, stool, colonoscopy and endoscopy. I'm sorry. I'm feeling so discouraged. I just know its going to be put down to IBS. And I personally feel that IBS is a throw away diagnosis when no one wants to investigate further.

Also, have you been tested for H. Pylori infection? I think I have seen that many ulcers can be attributed to that. It is also diagnosed with a breath test. Hang in there. Many people have been in your shoes. I wish it were easier.