[Morphological semeiotics of the celiac-sprue syndrome].

Sprue is a specific form of the gluten intolerance followed by the atrophy of villous structure and lengthening of crypts of the small intestine crypts. Hereditary factor has been implicated in its development and the immune hypothesis considering the sprue as a manifestation of the hypersensitivity to gluten is the most popular among the existing pathogenetic theories of this disease. The epithelium of atrophied villi reveals the most striking alterations. The content of lymphocytes in the epithelium is increased, high percentage of them being in the state of blast-transformation. The cells of the suppressor-cytotoxic type predominate among intraepithelial lymphocytes, the transfer of lymphocytes into the damaged epithelium is enhanced. Altered epitheliocytes have a smaller surface of the apical plasmalemma and a decreased activity of the associated enzymes. Intercellular epithelial contacts are altered and the basal membrane is damaged. There is an increase in number of T-lymphocytes and plasma cells synthesising IgA, IgM and IgG, in the thickened tunica propria of the small intestine mucous membrane. Lymphocytes-helpers predominate among T-lymphocytes and the ratio lymphocytes-helpers to lymphocytes of the suppressor-cytotoxic type is going down. Restoration of morphological alterations in the small intestine occurs when gluten is excluded from food.