Abstract
The leucocyte migration inhibition (LMI) test was used as an indicator of cell mediated immunity to gluten fraction III in 30 healthy controls and 58 patients with adult coeliac disease and the results related to HLA status and duration of treatment with a gluten-free diet. HLA-B8 controls showed significantly lower leucocyte migration indices, indicating greater immune response, than non-HLA B8 controls. Untreated coeliacs showed no difference from HLA-B8 controls. There was no difference between results from HLA-B8 and non-HLA-B8 coeliacs. Leucocyte migration was even lower in coeliacs early in treatment but rose after treatment for over one year. These results may reflect an immune response gene for gluten in linkage disequilibrium with HLA-B8. The increased immune response to gluten as measured in this test cannot be the sole factor in aetiology of coeliac disease. Furthermore, it is necessary to re-evaluate earlier results of cell-mediated immunity in coeliac disease with reference to HLA status of the controls.
Highlights
In normal controls who have HLA-B8 there is a significantly lower migration index, indicating greater immunity compared with those lacking HLA-B8
HLA status has been shown to affect immune response to several antigens in man"1 2:i and genetic analysis in one study has suggested that a single immune response gene is involved despite the complex nature of the antigen.'[3] Our results and previous work' " are consistent with there being an Immune response (Ir) gene for gluten in linkage disequilibrium with HLA-B8
The observation that many HLA-B8 normal individuals possess the proposed Ir gene for gluten suggests that possession of the gene may be necessary but is not sufficient for the development of coeliac disease, a position similar to that seen in HLA linked immune responses to ragweed pollen and the development of clinical hay fever.'[6]
Summary
This test was performed using a capillary tube method as previously described.[4]. The antigen used was gluten fraction III prepared from BDH gluten according to the method of Frazer et al.[10] and was used at a concentration of 1 mg/mI. Migration areas were measured by planimetry on traced projected images of the migration chambers and migration index calculated as mean area of migration in the presence of antigen divided by Received for publication 26 February 1981 mean area of migration of control chambers
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