Auricchio Renata, Paparo Francesco, Maglio Maria, Franzese Adriana, Lombardi Francesca, Valerio Giuliana, Nardone Gerardo, Percopo Selvaggia, Greco Luigi, Troncone Riccardo
Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy.
Diabetes. 2004 Jul;53(7):1680-3. doi: 10.2337/diabetes.53.7.1680.
Dietary gluten has been associated with an increased risk of type 1 diabetes. We have evaluated inflammation and the mucosal immune response to gliadin in the jejunum of patients with type 1 diabetes. Small intestinal biopsies from 17 children with type 1 diabetes without serological markers of celiac disease and from 50 age-matched control subjects were examined by immunohistochemistry. In addition, biopsies from 12 type 1 diabetic patients and 8 control subjects were cultured with gliadin or ovalbumin peptic-tryptic digest and examined for epithelial infiltration and lamina propria T-cell activation. The density of intraepithelial CD3(+) and gammadelta(+) cells and of lamina propria CD25(+) mononuclear cells was higher in jejunal biopsies from type 1 diabetic patients versus control subjects. In the patients' biopsies cultured with peptic-tryptic gliadin, there was epithelial infiltration by CD3(+) cells, a significant increase in lamina propria CD25(+) and CD80(+) cells and enhanced expression of lamina propria CD54 and crypt HLA-DR. No such phenomena were observed in control subjects, even those with celiac disease-associated HLA haplotypes. In conclusion, signs of mucosal inflammation were present in jejunal biopsies from type 1 diabetic patients, and organ culture studies indicate a deranged mucosal immune response to gliadin.
膳食中的麸质与1型糖尿病风险增加有关。我们评估了1型糖尿病患者空肠中针对麦醇溶蛋白的炎症和黏膜免疫反应。通过免疫组织化学检查了17名无乳糜泻血清学标志物的1型糖尿病儿童以及50名年龄匹配的对照受试者的小肠活检样本。此外，将12名1型糖尿病患者和8名对照受试者的活检样本用麦醇溶蛋白或卵清蛋白胰蛋白酶消化物培养，并检测上皮浸润和固有层T细胞活化情况。与对照受试者相比，1型糖尿病患者空肠活检样本中上皮内CD3(+)和γδ(+)细胞以及固有层CD25(+)单核细胞的密度更高。在用胰蛋白酶消化的麦醇溶蛋白培养的患者活检样本中，有CD3(+)细胞的上皮浸润，固有层CD25(+)和CD80(+)细胞显著增加，固有层CD54和隐窝HLA-DR的表达增强。在对照受试者中未观察到此类现象，即使是那些具有与乳糜泻相关的HLA单倍型的受试者。总之，1型糖尿病患者的空肠活检样本中存在黏膜炎症迹象，器官培养研究表明对麦醇溶蛋白的黏膜免疫反应紊乱。
