O'Gorman P, Bennett D, Kavanagh E, Twohig L B, O'Sullivan G C, O'Regan P, Shanahan F
Department of Medicine, National University of Ireland, Cork.
Am J Gastroenterol. 1996 Apr;91(4):723-5.
Recent reports suggest that appendectomy may protect against the development of ulcerative colitis. Depletion of mucosal helper T-cells is the suggested mechanism. Because mucosal T-cell activity has an even more critical role in the pathogenesis of celiac disease, our objective was to determine whether the development or mode of presentation of this disorder is influenced by appendectomy and/or tonsillectomy.
One hundred fifty consecutive adult celiac patients were compared with 138 consecutive patients examined at orthopedic clinics. One hundred twenty consecutive patients with ulcerative colitis from the same ethnogeographic population were included as positive disease control.
Contrary to the previous findings in ulcerative colitis, which were again confirmed in this study, appendectomy and/or tonsillectomy did not influence the occurrence of celiac disease. In addition, presenting features, predefined in the study protocol, did not differ significantly in the appendectomy and nonappendectomy celiac patients.
Resection of mucosa-associated lymphoid tissue (MALT) does not influence the occurrence or the mode of presentation of adult celiac disease. Therefore, in this classical example of a T-cell-mediated disorder, the hypothesis that surgical depletion of mucosal T-cells has a protective effect or influences the clinical manifestations cannot be supported.
近期报告表明，阑尾切除术可能预防溃疡性结肠炎的发生。推测其机制为黏膜辅助性T细胞耗竭。由于黏膜T细胞活性在乳糜泻发病机制中起更关键作用，我们的目的是确定这种疾病的发生或表现方式是否受阑尾切除术和/或扁桃体切除术的影响。
将150例连续的成年乳糜泻患者与138例在骨科诊所接受检查的连续患者进行比较。纳入来自同一民族地理区域的120例连续溃疡性结肠炎患者作为阳性疾病对照。
与本研究再次证实的溃疡性结肠炎的先前研究结果相反，阑尾切除术和/或扁桃体切除术不影响乳糜泻的发生。此外，研究方案中预先定义的表现特征在接受阑尾切除术和未接受阑尾切除术的乳糜泻患者中无显著差异。
黏膜相关淋巴组织（MALT）切除不影响成年乳糜泻的发生或表现方式。因此，在这个经典的T细胞介导疾病的例子中，黏膜T细胞手术耗竭具有保护作用或影响临床表现的假设不成立。
