Small-Bowel Cell-Loss and Weight-Loss in the Cœliac Syndrome

Croft, D N; Loehry, C A; Creamer, B.

doi:10.1016/s0140-6736(68)90354-1

Cited by 54 publications

(25 citation statements)

References 8 publications

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“…Croft et al [9] have estimated that half a million cells each minute are lost from a segment of small intestine 5 cm long, and Loehry el al. [23] have shown that iron is lost into the gut by this route.…”

Section: Discussionmentioning

confidence: 99%

Paneth Cell Secretion

Gent¹,

Creamer²

1972

Digestion

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The secretion of Paneth cells in the rat has been stimulated by pilocarpine, the small intestinal secretions have been collected and their free amino acid concentrations measured. Comparison with a control group of animals not given pilocarpine showed a statistically significant increase in the free amino acid concentrations. ⁶⁵Zn has been used to label Paneth cells in experiments which indicate that this increase in luminal amino acid concentrations is the result of the action of pilocarpine on the Paneth cell. Experiments using tritiated thymidine indicate that pilocarpine does not influence the rate of cell turnover in the rat small intestine. We conclude that the Paneth cell secretion is composed of amino acids.

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Section: Discussionmentioning

confidence: 99%

Paneth Cell Secretion

Gent¹,

Creamer²

1972

Digestion

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“…In a study of 11 patients with coeliac syndrome we found 4 patients with DNA rates higher than the upper limit of our group of patients with a normal small intestine [17]. These 4 patients were all clinically ill and at the time of study had lost more than 5 kg of body weight ( fig.…”

Section: Small Intestine: Coeliac Syndromementioning

confidence: 59%

“…In this condition cell loss from the mucosa is high in relation to the surface area of the mucosa and we have inferred from this that this is a high turnover condition [17], a conclusion that has recently been confirmed by the tritiated thymidine technique applied to human small intestinal biopsies [48]. In patients with coeliac syndrome who were losing weight, higher than normal DNA loss rates have been found, suggesting an even higher turnover in these ill patients.…”

Section: Small Intestine: Coeliac Syndromementioning

confidence: 67%

Gastro-Intestinal Cell Loss in Man

Croft

Cotton²

1973

Digestion

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The rate of deoxyribonucleic acid loss (DNA) from the epithelial surface of human stomach, small intestine, large intestine and skin measures the rate of cell loss. From the data it is apparent that 287 g of cells are lost every 24 h from the mucosa of the entire human gastrointestinal tract. Evidence is presented to show that in the steady-state this loss reflects the rate of production or turnover of surface epithelial cells. In atrophic gastritis, coeliac syndrome, exfoliative psoriasis and possibly ulcerative colitis turnover is high. The rate of cell loss in these diseases is high per unit of surface area. In patients with coeliac syndrome who are losing weight (active coeliacs) small bowel DNA rates are particularly high, and they fall to normal after successful treatment. There is both experimental animal, and human clinical evidence to show that in mal-absorptive states iron, protein, fat and folic acid are lost from the gut in excessive quantities. This increased endogenous loss of iron, protein and fat is related to the increased loss of DNA or cells. In the case of protein about 80 g are lost from the normal human small intestine per day, only 8–15% of which is derived from protein within cells. 12–30 g of lipid are lost per day from the human small bowel mucosa and it is virtually all derived from intracellular lipid within exfoliated epithelial cells. The term exfoliative enteropathy is suggested for this mechanism. We believe that excessive loss of endogenous material due to exfoliative enteropathy is an important cause of the malnutrition that results from diffuse diseases of the small intestine.

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“…This alteration in the distribution of the epithelium is in keeping with the known increase in exfoliation of surface cells, increased mitotic rate, and upward migration of crypt cells and increased enzyme activity within crypts at a site free from gluten damage (Creamer, 1967, Croft, Loehry, andCreamer, 1968;Trier and Browning, 1970;Morson and Dawson, 1972). The mean lamina propria volume increases only slightly (from 0-20 to 0-23 mm3/mml2 muscularis mucosae) despite the obvious increase in number of inflammatory cells (fig 10).…”

Section: The Patientsmentioning

confidence: 60%