Spencer J, Isaacson P G, MacDonald T T, Thomas A J, Walker-Smith J A
Department of Histopathology, University College, Middlesex School of Medicine, Bland Sutton Institute, London, England, UK.
Clin Exp Immunol. 1991 Jul;85(1):109-13. doi: 10.1111/j.1365-2249.1991.tb05690.x.
Gamma/delta T cells are increased in the gut epithelium of patients with coeliac disease compared with normal controls. The aim of this study was to determine whether the increase in gamma delta intraepithelial lymphocytes (IEL) is specific for coeliac disease, in which case it could be of diagnostic importance. Biopsies were obtained from children with no intestinal disease, coeliac disease, cow-milk-sensitive enteropathy/post-enteritis syndrome (CMSE PES) and miscellaneous other enteropathies (n = 67). Intraepithelial CD3+ and gamma delta T cells were identified in frozen sections using peroxidase immunohistochemistry. In normal biopsies there were 0-7 gamma delta IEL/100 cells in the epithelium. In untreated coeliac patients this increased to 9-22 gamma delta IEL/100 cells in the epithelium (P = 0.000004). Of 27 patients with morphologic intestinal damage which was not due to coeliac disease, four with CMSE/PES had gamma delta IEL/100 cells in the epithelium in the same range as the patients with coeliac disease. Of these, two had high densities of CD3+ IEL in the epithelium and were indistinguishable from patients with untreated coeliac disease. The other two could be excluded as possible coeliacs because their CD3+ IEL/100 epithelial cells were in the normal range. Thus an increase in gamma delta IEL is not specific for coeliac disease. However, enumeration of both of gamma delta IEL and CD3+ IEL densities will be useful in the exclusion of coeliac disease as a diagnosis in some children.
与正常对照组相比，乳糜泻患者肠道上皮中的γ/δ T细胞增多。本研究的目的是确定γδ上皮内淋巴细胞（IEL）的增加是否为乳糜泻所特有，若是如此，则可能具有诊断意义。对无肠道疾病、患有乳糜泻、牛奶敏感型肠病/肠炎后综合征（CMSE PES）以及其他各种肠病的儿童进行活检（n = 67）。使用过氧化物酶免疫组织化学在冰冻切片中鉴定上皮内CD3 +和γδ T细胞。在正常活检中，上皮中每100个细胞中有0 - 7个γδ IEL。在未经治疗的乳糜泻患者中，上皮中每100个细胞中的γδ IEL增加至9 - 22个（P = 0.000004）。在27例非乳糜泻所致形态学肠道损伤的患者中，4例CMSE/PES患者上皮中的γδ IEL/100细胞与乳糜泻患者处于相同范围。其中，2例上皮中CD3 + IEL密度较高，与未经治疗的乳糜泻患者无法区分。另外2例可排除乳糜泻可能，因为其每100个上皮细胞中的CD3 + IEL处于正常范围。因此，γδ IEL增加并非乳糜泻所特有。然而，γδ IEL和CD3 + IEL密度的计数在排除某些儿童乳糜泻诊断方面将很有用。
