The Distribution and Enteric Loss of ⁵¹Cr-Labelled Lymphocytes in Normal Subjects and in Patients with Coeliac Disease and Other Disorders of the Small Intestine

Abstract

Peripherally harvested lymphocytes have been labelled with ⁵¹Cr, reinjected into human subjects and their distribution then studied. Evidence is presented which suggests faecal loss of ⁵¹Cr represents loss of T lymphocytes and that there is normally a pathway of lymphocyte removal into the gut of probable importance in lymphocyte migration streams. In 9 normal subjects, without structural intestinal disease, faecal loss of lymphocytes over 5 days was 0.20 % (SEM ± 0.06) whereas in 5 patients with untreated coeliac disease faecal loss was 1.13 ± 0.34 %, in 7 with Crohn’s disease it was 1.01 ± 0.21 % and in 5 with intestinal lymphangiectasia loss was 0.61 ± 0.10%. In 1 patient with acute tropical sprue, enteric loss was 0.97 %. By contrast, faecal loss was normal in 3 coeliac patients in remission on a gluten-free diet. Measurements were also made using an external counter. In contrast to the normals, where count rates steadily diminished, an increasing activity was recorded over the umbilicus over 7 days after dose administration in all the disease categories studied with the exception of the treated coeliacs. The finding of an increased enteric loss of lymphocytes may explain many of the immunological abnormalities in the conditions studied.

The Effect of the Topical Steroid Clobetasone Butyrate on Coeliac Mucosa Maintained in Organ Culture

“…The loss of lymphocytes in culture without gluten is probably due to migration of these cells onto the surface of the biopsy by a pro cess similar to the intraluminal loss which has been documented in vivo (21), an effect which appeared to be inhibited by gluten. However, as in control mucosa some of the fall may also have been due to a relative increase in the enterocyte population (20).…”

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

“…Possible explanations for the low lymphocyte counts could be migration of lymphocytes in the intestinal mucosa, enteric loss and apoptosis of lymphocytes in the setting of the immune alterations of CD, and not least malnutrition (12,15,16). 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).…”

T Cell and OKM1-Positive Monocyte Populations in the Intestinal Lamina propria Mucosae and in the Peripheral Venous Blood in Crohn’s Disease

“…the peripheral venous blood, confirms our recent data [5] and also the majority of publications [1,18,19,22,24], The T suppressor populations, at a high index of activity of CD [according to Best et al,ref. 3] and without steroid treatment, was also found to be reduced, as indicated by the results of Pfreundschuh et al [19] and Godin and Sachar [11], Intestinal sequestration of the T cells as an increased enteric loss might serve to explain the detected altered status of mononuclear cells in CD [6].…”