Adaptive cell-proliferative changes in the small-intestinal mucosa in coeliac disease. 1982

A J Watson, and D R Appleton, and N A Wright

Cell proliferation in the small-intestinal crypts of rodents has been intensively investigated and lends itself to the deployment of techniques which are inapplicable in man. In particular there are ethical and economic objections to methods involving the use of tritiated thymidine in vivo for specific labelling of DNA, while the validity of in vitro studies using organ culture is uncertain. It is possible, nevertheless to construct a profile of the size and cytokinetic status of the mucosal crypts by analysis of serial sections prepared from well orientated routine diagnostic biopsy specimens. Such studies can provide a measure of mean total crypt-cell population, and by studying the distribution of mitoses in the crypts relative measurements can be obtained of proliferation and maturation compartment sizes, and of crypt cell production rate (CCPR). These parameters have been compared in 62 patients with 'flat' avillous coeliac mucosae and in 85 patients with normal villous mucosae. A heterogeneous group of 47 patients with lesser degrees of abnormality (convoluted mucosae) were similarly studied. In addition, estimates of cell cycle times were obtained in a small group of patients with normal, convoluted and 'flat' mucosae by taking biopsies before and after the administration of the metaphase-arresting agent vincristine. 'Flat' coeliac mucosae show a threefold increase in the size of the proliferation compartment compared with normal and the cell cycle time is approximately halved leading to a net sixfold increase in CCPR. This is the basis of the change in mucosal morphology and presumably represents a compensatory reaction to the gluten-induced increase in loss of enterocytes from the mucosal surface. Convoluted mucosae occupy an intermediate position in terms of the parameters studied and should be regarded as stages in a continuum of adaptive change.

UI MeSH Term Description Entries
D006965 Hyperplasia An increase in the number of cells in a tissue or organ without tumor formation. It differs from HYPERTROPHY, which is an increase in bulk without an increase in the number of cells. Hyperplasias
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D007421 Intestine, Small The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM. Small Intestine,Intestines, Small,Small Intestines
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002446 Celiac Disease A malabsorption syndrome that is precipitated by the ingestion of foods containing GLUTEN, such as wheat, rye, and barley. It is characterized by INFLAMMATION of the SMALL INTESTINE, loss of MICROVILLI structure, failed INTESTINAL ABSORPTION, and MALNUTRITION. Gluten Enteropathy,Sprue, Celiac,Sprue, Nontropical,Celiac Sprue,Gluten-Sensitive Enteropathy,Sprue,Disease, Celiac,Enteropathies, Gluten,Enteropathies, Gluten-Sensitive,Enteropathy, Gluten,Enteropathy, Gluten-Sensitive,Gluten Enteropathies,Gluten Sensitive Enteropathy,Gluten-Sensitive Enteropathies,Nontropical Sprue
D002455 Cell Division The fission of a CELL. It includes CYTOKINESIS, when the CYTOPLASM of a cell is divided, and CELL NUCLEUS DIVISION. M Phase,Cell Division Phase,Cell Divisions,Division Phase, Cell,Division, Cell,Divisions, Cell,M Phases,Phase, Cell Division,Phase, M,Phases, M
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003874 Dermatitis Herpetiformis Rare, chronic, papulo-vesicular disease characterized by an intensely pruritic eruption consisting of various combinations of symmetrical, erythematous, papular, vesicular, or bullous lesions. The disease is strongly associated with the presence of HLA-B8 and HLA-DR3 antigens. A variety of different autoantibodies has been detected in small numbers in patients with dermatitis herpetiformis. Duhring's Disease,Duhring Disease,Disease, Duhring,Disease, Duhring's,Duhrings Disease
D005260 Female Females

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