Magliocca F M, Bonamico M, Petrozza V, Correr S, Montuori M, Triglione P, Carpino F
Department of Human Anatomy, University of Rome La Sapienza, Italy.
Arch Histol Cytol. 1992;55 Suppl:125-30. doi: 10.1679/aohc.55.suppl_125.
The celiac disease syndrome is characterized by structural and ultrastructural alterations of the small intestine mucosa. According to criteria by European Society of Paediatric Gastroenterology and Nutrition, the conclusive diagnosis of celiac disease in children depends on the demonstration of histological relapse of the mucosa after reintroduction of gluten in the diet, as this syndrome is a permanent condition of gluten intolerance. Under these diseased conditions, the structure of the intestinal villi has been studied by light microscopy; morphological alterations were revealed only when the gluten challenge induced a clinical relapse. Scanning electron microscopy analyses of the intestinal mucosa in celiac diseased patients showed a strikingly uniform destruction of the villi with changes in their dimensions and arrangement. At high magnification the enterocytes were irregular in size and shape with a decrease and disruption of the glycocalyx. Reductions in length and density of microvilli were also clearly identified. Although these scanning electron microscopy findings could not demonstrate a relationship between the degrees of mucosal atrophy and the duration of the gluten challenge, they nevertheless revealed early stages of fine villous alterations that cannot be detected by the presently employed low resolution light microscopic techniques.
乳糜泻综合征的特征是小肠黏膜出现结构和超微结构改变。根据欧洲儿科胃肠病学和营养学会的标准，儿童乳糜泻的确切诊断取决于在饮食中重新引入麸质后黏膜组织学复发的证明，因为该综合征是麸质不耐受的一种永久性病症。在这些患病情况下，已通过光学显微镜研究了肠绒毛的结构；仅当麸质激发导致临床复发时才会显示形态学改变。对乳糜泻患者肠黏膜的扫描电子显微镜分析显示，绒毛明显均匀破坏，其尺寸和排列发生变化。在高倍放大下，肠上皮细胞的大小和形状不规则，糖萼减少和破坏。微绒毛的长度和密度降低也清晰可见。尽管这些扫描电子显微镜结果无法证明黏膜萎缩程度与麸质激发持续时间之间的关系，但它们揭示了目前使用的低分辨率光学显微镜技术无法检测到的早期细微绒毛改变阶段。
