Jones P E, Pallis C, Peters T J
J Neurol Neurosurg Psychiatry. 1979 May;42(5):402-6. doi: 10.1136/jnnp.42.5.402.
Gluten withdrawal from the diet is occasionally used speculatively in the management of multiple sclerosis. To assess whether there might be any rational basis for such a measure we have undertaken morphological and biochemical studies of the jejunal mucosa in 14 patients with multiple sclerosis. All were found to have morphologically normal villi, and quantitative estimation of surface-to-volume ratios gave values which did not differ from control subjects. Intraepithelial lymphocyte counts were normal. Antigliadin antibody titres were not raised in any patient. Estimation of activity of the brush border disaccharidases (sucrase, lactase, and maltase (showed that the mean level of each enzyme did not differ significantly from control subjects. Analytical subcellular fractionation of the biopsies showed no changes in the distribution or activity of marker enzymes for the brush order, lysosomes, mitochondria, cytosol, peroxisomes, or endoplasmic reticulum. It is concluded that there are no gross morphological or biochemical abnormalities in the jejunal mucosa in patients with multiple sclerosis and, therefore, that the use of gluten-free diets cannot be justified on the assumption that these patients suffer from a coeliac-like lesion of the small intestine.
饮食中去除麸质偶尔会被推测性地用于治疗多发性硬化症。为了评估这种措施是否有合理依据，我们对14例多发性硬化症患者的空肠黏膜进行了形态学和生化研究。结果发现，所有患者的绒毛形态均正常，表面体积比的定量估计值与对照组无差异。上皮内淋巴细胞计数正常。所有患者的抗麦醇溶蛋白抗体滴度均未升高。对刷状缘双糖酶（蔗糖酶、乳糖酶和麦芽糖酶）活性的估计表明，每种酶的平均水平与对照组无显著差异。活检组织的亚细胞分级分析显示，刷状缘、溶酶体、线粒体、胞质溶胶、过氧化物酶体或内质网的标记酶的分布或活性没有变化。结论是，多发性硬化症患者的空肠黏膜没有明显的形态学或生化异常，因此，基于这些患者患有小肠乳糜泻样病变的假设而使用无麸质饮食是不合理的。
