Abstract

Forty-seven peroral biopsy specimens of duodenojejunal mucosa showing convolutions were obtained from patients with a variety of clinical disorders. These mucosal samples were divided into three groups according to the extent of the convolutions and the severity of the accompanying histopathological changes; the cytokinetic status of the crypts in the three groups was then analysed and compared. Those in which the mucosae were predominantly or totally convoluted (group 3) showed the most notable cytokinetic changes: crypts were hyperplastic and crypt cell production rate was markedly increased compared with the other two groups and with morphologically normal control mucosae.

In the case of one patient with mucosal changes of group 3 severity, additional studies were carried out using vincristine to produce metaphase arrest. The cell cycle time of 27 hours was greatly shortened compared with a control value of 45 hours.

We find that the presence of convolutions in small-intestinal mucosal biopsy specimens is accompanied by an increase in the rate of cell production from the crypts, which is presumably related directly or indirectly to the rate of loss of mature enterocytes from the surface of the mucosa. Furthermore, an increase in the proportion of convolutions may reflect an increase in the rates of cell production and cell loss.

In the group 3 convoluted mucosae the cytokinetic profile of the crypts resembled that of some of the flat avillous coeliac mucosae previously studied although the rates of cell production did not reach the levels attained by the most productive of the flat coeliac mucosae.