Mosnier J F, Larvol L, Barge J, Dubois S, De La Bigne G, Hénin D, Cerf M
Service d'Anatomie et de Cytologie Pathologiques, Hôpital Beaujon, Clichy, France.
Am J Gastroenterol. 1996 Apr;91(4):709-13.
An increase of intraepithelial lymphocytes (IEL) is commonly found in lymphocytic colitis (LC) and collagenous colitis (CC), and has also been observed in the colonic mucosa of some patients with celiac disease or celiac-like disease. Thus, a similar mechanism could play a role in these apparently different entities. The aim of this work was to determine the phenotype of IEL and of lamina propria lymphocytes in the setting of LC and CC.
Biopsies were taken from all segments of the large bowel and from the ileon of eight patients with CC, four patients with LC, and 10 controls. An immunohistochemical study using monoclonal antibodies directed against IEL, T-cells, helper T-cells, suppressor/cytotoxic T-cells, HLA DR antigens, T-cell-bearing T-cell receptor (TcR) alpha beta, and TcR gamma delta was carried out.
There was an increased in mean numbers of IELs in both LC and CC, with significantly more CD 8 IELs than CD 4 IELs. Most IELs were bearing TcR alpha beta; TcR gamma delta-bearing cells were not increased in CC or LC. CD 4+ helper T-cells predominated in the lamina propria. Epithelial cells of colonic mucosa abnormally expressed HLA DR antigens. There were no significant differences between findings in LC and CC.
This study suggests that the immune abnormalities are similar in LC and CC and that a MHC-restricted immune mechanism could be involved in both diseases. Evidence for this includes: 1) the accumulation of CD 4+ T-cells within the lamina propria, 2) epithelial damage closely related to the increase of CD 8 TcR alpha beta IELs, and 3) abnormal class II MHC molecule expression on epithelial cells of colonic mucosa. Furthermore, the results suggest that the putative immune mechanisms underlying LC or CC are probably different from those that are incriminated in celiac disease.
上皮内淋巴细胞（IEL）增多常见于淋巴细胞性结肠炎（LC）和胶原性结肠炎（CC），在一些乳糜泻或乳糜泻样疾病患者的结肠黏膜中也有观察到。因此，类似的机制可能在这些明显不同的疾病中起作用。本研究的目的是确定LC和CC背景下IEL及固有层淋巴细胞的表型。
从8例CC患者、4例LC患者和10例对照者的大肠各段及回肠取材进行活检。采用针对IEL、T细胞、辅助性T细胞、抑制/细胞毒性T细胞、HLA DR抗原、携带T细胞受体（TcR）αβ的T细胞和TcRγδ的单克隆抗体进行免疫组织化学研究。
LC和CC中IEL的平均数量均增加，CD8⁺ IEL明显多于CD4⁺ IEL。大多数IEL携带TcRαβ；CC和LC中携带TcRγδ的细胞未增加。固有层中CD4⁺辅助性T细胞占主导。结肠黏膜上皮细胞异常表达HLA DR抗原。LC和CC的研究结果之间无显著差异。
本研究表明，LC和CC的免疫异常相似，且两种疾病可能都涉及MHC限制的免疫机制。证据包括：1）固有层内CD4⁺ T细胞的积聚；2）上皮损伤与CD8 TcRαβ IEL的增加密切相关；3）结肠黏膜上皮细胞上II类MHC分子表达异常。此外，结果表明，LC或CC潜在的免疫机制可能与乳糜泻中涉及的机制不同。
