AGE DEPENDENT MUCOSAL INFLAMMATORY CELL RESPONSE IN COELIAC DISEASE

Abstract

We have studied the influence of age on the alterations of mucosal T-cells, immunoglobul in containing cells and monocytes caused by exposure to gliadin in coeliac disease (CD).Following groups were investigated: Patients with active CD aged 8-12 months (n=7), 24-55 months (n=9) and 9-54 years (n=4). Controls aged 10-29 months (n=7) and 21-76 years (n=5). Subsets of inflammatory cells were counted on frozen sections and on paraffin embeded material stained with commercial monoclonal and polyclonal antibodies.A significant increase of the number of intraepithelial lymphocytes (IEL) and lamina propria lymphocytes (LPL) was found in all age groups with active CD, as reported earlier. The ratio CD4+LPL to CDB+LPL was lower during infancy (1.0) than in older patients (1.3) due to a lower number of CD4+LPL in the infants. The same pattern was observed in the controls, with the ratio 1.1 in children and 1.6 in adults. The number of immunoglobulin containing cells (IgG, IgA, IgM) in tha lamina propria was lower in the young controls than in the adult ones. In active CD there was a marked increase of IgA containing cells in all age groups. The increase of IgM containing cells was more pronounced in the younger patients than in the older, while a minor increase of IgG containing cells occurred in all the patients. There was also a more prominent increase of monocytes in children than in adult patients. The observed differences may explain the age variation of the clinical course of coeliac disease.