Clinical–Alimentary TractParadoxical coexpression of proinflammatory and down-regulatory cytokines in intestinal T cells in childhood celiac disease☆,☆☆
Section snippets
Patients and biopsy sampling
Intestinal biopsy specimens were collected from children admitted to the Department of Pediatrics at the University Hospital of Northern Sweden, Umeå, on suspicion of CD. One or two adjacent biopsy specimens were collected from distal duodenum/proximal jejunum at the region of the ligament of Treitz by using a Watson pediatric capsule; part of 1 biopsy sample was used for routine pathology examination and grading by the Alexander score14 and the rest for cytokine analyses. On the same day, a
Study design, T-cell isolation, and preliminary cytokine mRNA screening
T cells were isolated from the epithelial (CD3+ IEL) and lamina propria (CD3+ LPL) compartments of jejunum biopsy samples from children with CD and control patients with no known food intolerance and proven normal intestinal histology (Figure 1A and B). Biopsy specimens from CD patients were from patients presenting with active disease (untreated CD), from patients treated with a glutenfree diet for more than 7 months with normalized histology (treated CD), and from patients challenged with a
Discussion
To the best of our knowledge this is the first study in which the cytokine mRNA expression in isolated intestinal T cells of children has been determined in the absence of in vitro stimulation. The experimental approach using real-time quantitative RT-PCR in combination with the unique clinical material from children belonging to CD patients with active and inactive disease or patients with no known food intolerance has generated several novel insights. First, T cells in the normal small
Acknowledgements
The skillful technical assistance of Marianne Sjöstedt, Elisabeth Granström, and Yvonne Andersson is gratefully acknowledged.
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Address requests for reprints to: Prof. Marie-Louise Hammarström, Immunology, Umeå University, SE-90185 Umeå, Sweden. e-mail: [email protected]; fax: (46) 90-7852250.
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Supported by grants from the Swedish Natural Science Research Council (to M.-L.H), the Swedish Foundation for Health Care Sciences and Allergy Research (to M.-L.H and O.H.), the Swedish Medical Research Council (to O.H.), the Medical Faculty of Umeå University (to M.-L.H.), and the County of Västerbotten (to O.H. and M.-L. H.).