Leonard N, Hourihane D O, Whelan A
Department of Histopathology, St James's Hospital, Dublin, Ireland.
Gut. 1995 Dec;37(6):763-5. doi: 10.1136/gut.37.6.763.
The pathogenesis of villous damage in coeliac disease is unknown. Change to the delicate neuromuscular core may be significant and this study stained various categories of coeliac disease and controls with neuron-specific enolase (NSE) to examine neurofilaments in the mucosa. The amount of NSE staining was evaluated using computer image analysis. The first part of the study compared coeliac disease with Crohn's disease, carcinoma, and biopsy specimens from normal subjects. There was increased NSE staining in both the coeliac disease and Crohn's disease cases but not in carcinomas or normal controls. This difference was statistically significant. The average value for the coeliac disease patients was 50% higher than that of Crohn's disease patients. The second part of the study compared treated coeliac disease with untreated coeliac disease. Treated coeliac disease cases had normal amounts of NSE staining, which were the same as normal controls. These findings suggest that neuroproliferation is a feature of coeliac disease and Crohn's disease. Both share a common feature--namely chronic inflammation--which has been occasionally associated with neuroproliferation. The fact that neuroproliferation resolves with treatment is further evidence for its association with chronic inflammation. The extra neuroproliferation seen in coeliac disease compared with Crohn's disease may contribute to the architectural abnormalities seen in coeliac disease.
乳糜泻中绒毛损伤的发病机制尚不清楚。对精细的神经肌肉核心的改变可能具有重要意义，本研究用神经元特异性烯醇化酶（NSE）对各类乳糜泻患者和对照组进行染色，以检查黏膜中的神经丝。使用计算机图像分析评估NSE染色量。研究的第一部分将乳糜泻与克罗恩病、癌以及正常受试者的活检标本进行比较。乳糜泻和克罗恩病病例的NSE染色均增加，但癌和正常对照组则无此现象。这种差异具有统计学意义。乳糜泻患者的平均值比克罗恩病患者高50%。研究的第二部分将经治疗的乳糜泻与未经治疗的乳糜泻进行比较。经治疗的乳糜泻病例的NSE染色量正常，与正常对照组相同。这些发现表明神经增生是乳糜泻和克罗恩病的一个特征。两者都有一个共同特征，即慢性炎症，而慢性炎症偶尔与神经增生有关。神经增生在治疗后消退这一事实进一步证明了它与慢性炎症的关联。与克罗恩病相比，乳糜泻中额外的神经增生可能导致了乳糜泻中所见的结构异常。
