Alpha/beta intraepithelial lymphocytes, serum gliadin antibodies and allergy test positivity in children

Abstract

Aim: To determine whether the amount of αβ‐positive intraepithelial lymphocytes (IELs) is connected to allergy test positivity in children with gastrointestinal symptoms and whether elevated serum gliadin antibodies have any role in the diagnosis. Methods: Twenty‐seven children suffering from gastrointestinal‐symptoms in whom intestinal biopsies had previously been obtained via endoscopy or with capsule biopsy to exclude coeliac disease were included into the study. The other inclusion criteria were increased amounts of CD3 and αβ‐positive IELs with normal amounts of γδ‐positive IELs in duodenal or jejunal biopsy specimens. At the control visit, the children underwent a physical examination and parents filled in a questionnaire concerning gastrointestinal‐and atopic symptoms. Skin prick‐ and patch tests were done and serum gliadin, endomysium, transglutaminase antibodies and specific IgEs were measured. Results: Only nine children (33%) had at least one positive result in the allergy tests, the rest remaining test negative. In children with digestive symptoms, IgG‐class gliadin antibody titres were higher than those of the non‐symptomatic children. A significant correlation was found between IgG‐class gliadin antibodies and total amount of αβ‐positive IELs (p= 0.017). Conclusion: No positive skin test or specific IgE positivity for cereals in children with high intestinal T‐cell densities was observed. The correlation between IgG‐class gliadin antibodies and the total amount of αβ‐TCR positive‐cells is likely to be a reflection of local immune response of the gut.