Immunochemical Studies of the Serum, Intestinal Secretions and Intestional Mucosa in Patients with Adult Celiac Disease and Other Forms of the Celiac Syndrome

Enzyme Activities and Properties of Lysosomes and Brush Borders in Jejunal Biopsies from Control Subjects and Patients with Coeliac Disease

“…Fraser (1956) suggested that the specific deficiency of a mucosal peptidase, essential for the breakdown of gluten, resulted in accumulation of 'toxic' fractions of gluten and that these, in some way, were responsible for mucosal damage. More recently, there has arisen evidence supporting a second hypothesis-that immunological mechanisms play a primary role in the pathogenesis of coeliac disease (Douglas, Crabbe & Hobbs, 1970;Doe, Henry, Holt & Booth, 1972;Shiner, 1973). When gluten is reintroduced into the diet of successfully treated coeliac patients, an acute inflammatory reaction occurs in the intestinal mucosa with increased synthesis of IgA and IgM by the mucosa (Loeb, Strober, Falchuk & Laster, 1971).…”

Immunoglobulins in the jejunal mucosa in adult coeliac disease and dermatitis herpetiformis after the reintroduction of dietary gluten.

“…However, the increased numbers and abnormal predominance of IgM over IgA containing cells in the jejunal mucosa of patients with ACD (Crabb and Heremans, 1966;Douglas et al, 1970;Soltoft, 1970;Pettingale, 1971;Savilahti, 1972;Lancaster-Smith et al, 1974) suggest that humoral immune mechanisms may be involved. Additional evidence for this is provided by the ultrastructural changes (Shiner, 1973) and deposition of immunoglobulins in the small intestinal mucosa of treated patients (Shiner and Ballard, 1972;Doe et al, 1974) after gluten challenge.…”

Coeliac disease and autoimmunity

“…The proportion of positive autoantibody tests found in this study is comparable to that found by Seah et al (1971), but our group of thirty-one patients included seven with other disorders who accounted for fifteen of the twenty tests (Table 2). Coeliac disease has been described by Hobbs as a 'localized dysgammaglobulinaemia' as evidenced by an abnormal plasma cell population of the jejunum and immunoglobulin concentrations in the jejunal juice (Douglas, Crabbe and Hobbs, 1970).…”

“…More recently Fakhri and Hobbs (1972) suggested that the 'nonimmune' lymphocyte might be involved in the development of both coeliac disease and autoimmune conditions such as thyroiditis. It is possible in a minority of cases more than one target tissue could be involved in the same patient.…”