expression of TSLP and its receptor (TSLP-R) in the duodenal mucosa of patients affected by RCD. Methods Duodenal biopsies were collected from 12 RCD patients, 16 uncomplicated CD patients before and after 12 months of gluten-free diet, and 14 control subjects. The gene expression of TSLP and TSLP-R was evaluated on biopsy homogenates by quantitative RT-PCR, and the data were normalised for cytokeratin 18 expression. The protein expression of TSLP and TSLP-R was studied on biopsy homogenates by immunoprecipitation and on biopsy sections by confocal microscopy. Results In vivo mucosal TSLP expression was significantly reduced both at the mRNA and protein levels in the duodenum of RCD and untreated CD patients compared to treated CD patients and controls, without differences between RCD and untreated CD patients and between treated CD patients and controls. TSLP transcript down-regulation in untreated CD mucosa was confirmed after normalisation for cytokeratin 18. TSLP-R was expressed in the duodenal mucosa both at the gene and the protein level, without significant differences between RCD, untreated and treated CD patients and control subjects. Confocal microscopy analysis confirmed these findings. Conclusion TSLP expression is primarily reduced in the duodenal mucosa of RCD patients. Further studies are needed to clarify the influence of TSLP reduction on the process of immunosurveillance in RCD. 10.1136/gutjnl-2014-307263.564 Introduction Coeliac disease (CD) is a common autoimmune condition affecting 1% of the adult population. However large numbers of patients remain undiagnosed which may have significant health consequences. Guidelines suggest that at least 4 duodenal biopsies should be taken to rule out CD. A previous US study showed that biopsy guidelines were only followed in 35% of cases. The aim of the present study was to see whether guidelines were being followed in the UK and if adherence to the guidelines improved detection of CD. Methods Endoscopy and histology reports were retrospectively reviewed for all patients who had a duodenal biopsy in a 3 month period between November 2012 and January 2013 from 4 UK hospitals. Indications for biopsy, role of the endoscopist, number of duodenal biopsies received by histopathology and the final diagnosis were recorded. The presence of villous atrophy was required for CD diagnosis. Patients were excluded if they had known CD. The difference between a double and single bite biopsy technique was also assessed. Results 1423 patients underwent duodenal biopsy for possible CD across the 4 sites in the study period. 97 (6.8%) of these were diagnosed with CD. Guidelines to take at least 4 biopsies were met in 40% of patients and the median number of duodenal biopsies taken for all patients was 3. CD diagnosis was more likely guidelines were followed (10.1 vs. 4.6% p < 0.0001). The median number of biopsies was greater in patients diagnosed with CD (4 vs. 3) p < 0.0001. Gastroenterologists and nurse endoscopists were more likely than surgeons to follow guidelines...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.