Gallagher R B, Kelly C P, Neville S, Sheils O, Weir D G, Feighery C F
Department of Immunology, Trinity College, Dublin, Ireland.
Gut. 1989 Nov;30(11):1568-73. doi: 10.1136/gut.30.11.1568.
Complement activation may play an important role in the pathogenesis of coeliac disease. In the present study immunohistochemical localisation of C3 and of a neoantigen exposed only on the terminal C5b-9 complement complex has been performed on small intestinal biopsy sections from newly diagnosed untreated coeliac patients, from coeliac patients on long-term gluten-free diet and from disease controls. Levels of C3 were markedly increased in treated coeliac patients compared with controls. Staining of C3 was concentrated subepithelially and within the centre of the lamina propria. No staining was detected at these sites using antibody to the neoantigen, however, strongly suggesting that the increased levels of C3 seen in the coeliac patients was the result of increased extravasation of serum proteins rather than complement activation. Surprisingly, complement activation was detected within the glands of Brunner. Positive staining using anti-C5b-9 neoantigen was found in all coeliac patients, both treated and untreated. Three of the 13 disease controls also showed reactivity with this antibody. This novel finding suggests that Brunner's glands, hitherto largely neglected structures, may play an important role in the development of coeliac disease.
补体激活可能在乳糜泻的发病机制中起重要作用。在本研究中，对新诊断的未经治疗的乳糜泻患者、长期接受无麸质饮食的乳糜泻患者以及疾病对照的小肠活检切片进行了C3和仅在终末C5b - 9补体复合物上暴露的新抗原的免疫组织化学定位。与对照组相比，接受治疗的乳糜泻患者的C3水平显著升高。C3染色集中在黏膜上皮下和固有层中心。然而，使用针对新抗原的抗体在这些部位未检测到染色，这强烈表明乳糜泻患者中所见的C3水平升高是血清蛋白外渗增加的结果，而非补体激活。令人惊讶的是，在布伦纳腺内检测到补体激活。在所有接受治疗和未接受治疗的乳糜泻患者中均发现使用抗C5b - 9新抗原的阳性染色。13名疾病对照中有3名也显示出与该抗体的反应性。这一新发现表明，布伦纳腺这一迄今很大程度上被忽视的结构，可能在乳糜泻的发展中起重要作用。
