Histomorphology of healthy oral mucosa in untreated celiac patients: unexpected association with spongiosis

Campisi, Giuseppina; Compilato, Domenico; Iacono, Giuseppe; Maresi, Emiliano; Liberto, Chiara Di; Marco, Vito Di; Fede, Gaetana Di; Craxı̀, Antonio; Carroccio, Antonio

doi:10.1111/j.1600-0714.2008.00677.x

Cited by 8 publications

(9 citation statements)

References 64 publications

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“…These results have been confirmed by a recent study [48] in which no differences were observed in CD3+ count or B-and T-lymphocyte counts, either in the epithelium or the lamina propria of the clinically healthy oral mucosa in untreated CD patients and in controls. This seemed to confirm that the oral mucosa does not reflect the intestinal damage of CD.…”

Section: Role Of the Mouth And Oral Mucosa In CD Studiessupporting

confidence: 81%

“…However, the previous observation of consistent inflammatory infiltration of the oral mucosa of CD patients on a GFD led us to hypothesize that an immunological "memory" of gluten hypersensitivity can be created. According to this hypothesis, the same authors [48] evaluated the reaction of oral mucosa to a local gluten challenge [41,42]. They demonstrated that oral supramucosal application and a submucosal injection of gliadin powder or gliadin peptides into patients with treated CD induced significant immunological changes, displayed by an increase in intraepithelial CD4+ T cells, as well as CD4+ and CD8+ T cells in the lamina propria.…”

Section: Role Of the Mouth And Oral Mucosa In CD Studiesmentioning

confidence: 99%

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The Production of the Oral Mucosa of Antiendomysial and Anti—Tissue-Transglutaminase Antibodies in Patients with Celiac Disease: A Review

Compilato¹,

Campisi²,

Pastore

et al. 2010

The Scientific World JOURNAL

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Celiac disease (CD) is a lifelong, T cell—mediated enteropathy, triggered by the ingestion of gluten and related prolamins in genetically susceptible subjects, resulting in minor intestinal mucosal injury, including villous atrophy with crypt hyperplasia and intraepithelial lymphocytosis, and subsequent nutrient malabsorption. Although serological tests for antiendomysial (EMA) and anti—tissue transglutaminase (anti-tTG) autoantibodies are used to screen and follow up on patients with CD, diagnostic confirmation is still based on the histological examination of the small intestinal mucosa. Although the small intestinal mucosa is the main site of the gut involved in CD, other mucosal surfaces (such as gastric, rectal, ileal, and esophageal) belonging to the gastrointestinal tract and the gut-associated lymphoid tissue (GALT) can also be involved. A site that could be studied less invasively is the mouth, as it is the first part of the gastrointestinal system and a part of the GALT. Indeed, not only have various oral ailments been reported as possible atypical aspects of CD, but it has been also demonstrated that inflammatory changes occur after oral supramucosal application and a submucosal injection of gliadin into the oral mucosa of CD patients. However, to date, only two studies have assessed the capacity of the oral mucosa of untreated CD patients to EMA and anti-tTG antibodies. In this paper, we will review studies that evaluate the capacity of the oral mucosa to produce specific CD autoantibodies. Discrepancies in sensitivity from the two studies have revealed that biopsy is still not an adequate procedure for the routine diagnostic purposes of CD patients, and a more in-depth evaluation on a larger sample size with standardized collection and analysis methods is merited. However, the demonstration of immunological reactivity to the gluten ingestion of the oral mucosa of CD, in terms of IgA EMA and anti-tTG production, needs to be further evaluated in order to verify whether the oral mucosa is colonized by lymphocytes activated in the intestine or if gluten could stimulate naïve lymphocytes directly in the oral mucosa. This would have important implications for the pathogenesis, diagnosis, and treatment of CD.

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Section: Role Of the Mouth And Oral Mucosa In CD Studiessupporting

confidence: 81%

Section: Role Of the Mouth And Oral Mucosa In CD Studiesmentioning

confidence: 99%

The Production of the Oral Mucosa of Antiendomysial and Anti—Tissue-Transglutaminase Antibodies in Patients with Celiac Disease: A Review

Compilato¹,

Campisi²,

Pastore

et al. 2010

The Scientific World JOURNAL

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“…The findings from Bardellini et al (27) and other similar observations (29) are however opposed to other recent studies (30,31) which found no differences regarding oral mucosa lymphocyte infiltrate in CD patients when compared with healthy controls. Therefore, more studies similar to the one by Bardellini et al (27) should be performed including larger multi-center cohorts and a blinded comparison of the duodenal and buccal immunohistochemistry analysis to confirm their findings.…”

contrasting

confidence: 77%

Coeliac disease in the oral mucosa?

Bernardo

2014

Rev. esp. enferm. dig.

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“…Recent studies (13,25) have shown no differences regarding the B-and T-lymphocyte (including CD3+) counts, both in the epithelium and in the lamina propria of the oral mucosa of CD patients and controls. However the same studies demonstrated that the oral mucosa was unexpectedly affected by spongiosis, probably linked to a local toxic effect which, in turn, was induced by gluten.…”

Section: Discussionmentioning

confidence: 99%

Histopathological findings in the oral mucosa of celiac patients

Bardellini

Amadori

Ravelli

et al. 2014

Rev. esp. enferm. dig.

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Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible subjects. Although the small intestinal mucosa is the main site of the gut's involvement in CD, other mucosal surfaces belonging to the gastrointestinal tract and the gut-associated lymphoid tissue are known to be affected.Aim: Assuming that the oral mucosa could reflect the histopathological inflammatory alterations of the intestine in CD patients, this study wishes to assess the pattern of T-cell subsets in the oral mucosa of young adults with CD.Methods: A group of 37 patients (age range 20-38 years; female: male ratio 28:9) with CD were enrolled. Out of 37 patients, 19 patients (group A) followed a gluten free diet (GFD) -2 patients from less than one year; 6 patients between 1 and 5 years; 11 patients more than 5 years-while 18 patients (group B) were still untreated. Fifteen healthy volunteers (age range 18-35 years, female: Male ratio 11:4) served as controls for the CD patients. Ethical approval for the research was granted by the Ethics Committee. Biopsy specimens were taken from normal looking oral mucosa. The immunohistochemical investigation was performed with monoclonal antibodies to CD3, CD4, CD8, and γδ-chains T cell receptor (TCR).Results: The T-lymphocytic inflammatory infiltrate was significantly (p < 0.0001) increased in group B (both compared with group A and with the control group).Conclusion: This study confirms the oral cavity to be a site of involvement of CD and its possible diagnostic potentiality in this disease.

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Histomorphology of healthy oral mucosa in untreated celiac patients: unexpected association with spongiosis

Cited by 8 publications

References 64 publications

The Production of the Oral Mucosa of Antiendomysial and Anti—Tissue-Transglutaminase Antibodies in Patients with Celiac Disease: A Review

The Production of the Oral Mucosa of Antiendomysial and Anti—Tissue-Transglutaminase Antibodies in Patients with Celiac Disease: A Review

Coeliac disease in the oral mucosa?

Histopathological findings in the oral mucosa of celiac patients

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