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Refractory Celiac Disease: Unlocking the Origin of Aberrant Lymphocytes

Celiac.com 10/25/2012 - Abnormal intraepithelial lymphocytes (IELs) are the main feature of refractory celiac disease type II (RCDII). However, researchers still don't know exactly how these abnormal IELs originate.

Photo: CC--W. D. VanlueA pair of researchers recently commented on efforts to learn how these abnormal IELs might come about.

The pair were Victor F. Zevallos, and Detlef Schuppan, of the center for Molecular and Translational Medicine, Department of Medicine I at the University Medical Center of Johannes Gutenberg University Mainz, in Mainz, Germany.

Their commentary focuses on efforts by a separate research team, Schmitz, et al., which had already used a broad spectrum of cell specific markers, RNA array and immunological techniques, to explore abnormal IEL cell lines from four RCDII patients, and compare them with IELs from the fetal intestine, the intestine of children and adults and the thymus.

IELs are highly varied lymphocytes cells with innate and adaptive features that live in the small and large intestine. IELs play an important role in maintaining gut tolerance to common food antigens versus defense against pathogens.

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A number of nutritional factors influence the development and spread of IELs, especially vitamins and their active metabolites, such as retinoic acid, and phytochemicals such as ligands of the aryl hydrocarbon receptor from cruciferous vegetables.

However, when IELs activate and expand uncontrollably in response to chronic inflammatory conditions in the gut, they trigger mucosal damage, which can lead to celiac disease, and in some cases, to malignant cancers.

Up to 5% of people with celiac disease, especially those who are over fifty years old when diagnosed, continue to suffer from clinical symptoms and villous atrophy even when following a gluten-free diet.

After excluding ongoing gluten consumption and other potential underlying diseases, all four patients studied by Schmitz could be diagnosed with RCD, which is classically classified as type I or type II, based on the histological co-expression of CD3 and CD8 in RCDI, or absence of such co-expression in RCDII.

Read the entire report in Gut.

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2 Responses:

 
Barb
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said this on
29 Oct 2012 5:38:57 PM PDT
They may be eating other grains that have a type of gluten in ithem. I can't eat corn and such things myself.

 
Greg Marlow
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said this on
30 Oct 2012 7:41:48 AM PDT
Abnormal IELs appeared on my lips about one year before clinical symptoms of celiac disease. The dermatologist called them Fordice spots. She had no idea that they might be related to celiac disease.




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Last December, I was horribly sick. Suddenly, questioning gluten; I didn't eat any. The change was beyond enormous, and I could not ever bring myself to voluntarily eat it, again. It was as if I was finally, not being electrocuted! A nasty, blistering rash went away, at the same time. Now, I am ...

Same here. Our doctor told us that my daughter does not have celiac right after the endoscopy. We were overjoyed. 2 weeks later, they called and gave us the test results, and that she does have celiac. I would wait at least until the actual results before worry about next steps.

Peanut butter is always my breakfast when I want to stay full for a while. When I am in a rush, I just eat a spoon of peanut butter and a glass of milk with some fruit. When I have a bit more time, I make toast with peanut butter. Cereal doesn't keep me full in general. I know you said you ...

My GI said the same thing, but he warned me that we would have to wait for the pathologist's report. Guess what? The report showed moderate to severe patches of intestinal damage. So, hang in there and just wait for those results.

What sort of side effects did you have? I feel like I still have acid every morning, upset stomach, bloating, burping, and poor tolerance to most food.