T cell depletion in untreated adult coeliac disease.

Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease

“…This has also been seen in other small bowel disorders such as protein-losing enteropathies, where fecal loss of lymphocytes and alterations in lymphocyte subpopulations have been documented (17,18). In accordance with the findings of others (19) who reported lymphocyte counts returning to normal on GFD, we have also seen a significant increase in lymphocyte counts in GFD-treated patients; this is probably due to a decrease in lymphocyte leakage through the healed mucosa (Table 1). However, mean lymphocyte counts in GFD treated CD patients do not reach the values of healthy controls; in fact, treated CD patients do not complete reverse the mucosal alterations as to a healthy person, and this has been reinforced by two studies reporting persistent duodenal intraepithelial lymphocytosis even in long-term strictly adherent patients (20,21).…”

Immune Phenotype of Children with Newly Diagnosed and Gluten-Free Diet-Treated Celiac Disease

“…The differences in activated lymphocyte prevalence values indicate a systemic inflammation in CD and supports a notion of a general alteration of adaptive immunity in children with CD. However, while our observations correspond to previous reports about adult CD, they apparently contradict to those obtained in CD biopsy samples indicating a marked difference between local immune milieu and systemic immune phenotype [30,31].…”

“…These data raise the notion that the lowerthan-normal CD4 ? and Th1 cell prevalence in blood may be, at least partly, due to their accumulation in the affected organs [30,31].…”

Systematic review: the evidence base for long‐term management of coeliac disease

“…Untreated patients have significantly reduced levels of leucocytes, total lymphocytes, and CD3+, CD4+ and CD8+ lymphocytes compared to those with treated CD and to the general population. [61][62][63] Hyposplenism ⁄ splenic sequestration (see Table 1) is one mechanism. The proportion of natural killer and cytotoxic T cells is lower in untreated and treated coeliac patients than in healthy populations, postulated to be because of sequestration of lymphocytes within the intestinal mucosa and ⁄ or because of their loss into the gut lumen.…”