Steel Daniella M, Ryd Walter, Ascher Henry, Strandvik Birgitta
Department of Paediatrics, Göteborg University, Göteborg, Sweden.
J Pediatr Gastroenterol Nutr. 2006 Sep;43(3):318-23. doi: 10.1097/01.mpg.0000228107.98863.45.
Celiac disease (CD) is characterized by chronic inflammation of the small intestinal mucosa with disturbed epithelial transport. The fatty acid (FA) composition of intestinal membranes is important for epithelial function, and disturbances may contribute to the pathophysiology of the disease. We aimed to evaluate whether the intestinal mucosal FA status was reflected in serum phospholipids of patients with CD.
Samples were obtained from 7 pediatric patients with active CD showing mucosal atrophy, 6 pediatric patients with CD in remission, and 11 control pediatric patients with morphologically healthy intestinal mucosa. Small intestinal biopsies were obtained using a Watson biopsy capsule under fluoroscopic control. Blood samples were collected on the same morning after an overnight fast. Tissue phospholipids were isolated by high-performance liquid chromatography, and FAs were analyzed by capillary gas-liquid chromatography.
Serum phospholipid FA showed marginal differences between the patients with CD and the controls. Significant differences were observed in mucosa with active CD compared with controls. Linoleic acid (18:2n-6) level was decreased, whereas those of its derivatives were elevated, indicating increased transformation of n-6 FA. Mead acid (20:3n-9) level was increased, with an increased ratio of Mead acid to arachidonic acid (20:4n-6) levels, suggesting essential fatty acid deficiency. The n-3 FA levels were not significantly changed. During remission, the FA pattern of the intestinal mucosa was mainly similar to that in controls.
The FA abnormality of intestinal mucosa in patients with active CD was not reflected in serum values. Altered FA content may contribute to the pathophysiology of the disease because FAs are important for enzymes and for the transport and receptor functions of epithelial membranes.
乳糜泻（CD）的特征是小肠黏膜慢性炎症伴上皮转运紊乱。肠膜的脂肪酸（FA）组成对上皮功能很重要，其紊乱可能导致该疾病的病理生理学改变。我们旨在评估CD患者血清磷脂中是否反映了肠黏膜FA状态。
样本取自7名患有活动性CD且有黏膜萎缩的儿科患者、6名缓解期CD儿科患者以及11名肠道黏膜形态健康的对照儿科患者。在荧光镜控制下使用沃森活检胶囊获取小肠活检样本。禁食过夜后的同一天早晨采集血样。通过高效液相色谱法分离组织磷脂，并用毛细管气液色谱法分析脂肪酸。
CD患者与对照组之间血清磷脂FA存在微小差异。与对照组相比，活动性CD患者的黏膜存在显著差异。亚油酸（18:2n - 6）水平降低，而其衍生物水平升高，表明n - 6 FA转化增加。二十碳三烯酸（20:3n - 9）水平升高，二十碳三烯酸与花生四烯酸（20:4n - 6）水平的比值增加，提示必需脂肪酸缺乏。n - 3 FA水平无显著变化。缓解期，肠黏膜的FA模式主要与对照组相似。
活动性CD患者肠黏膜的FA异常未在血清值中体现。FA含量改变可能导致该疾病的病理生理学改变，因为FA对酶以及上皮膜的转运和受体功能很重要。
