Abstract
Intestinal dipeptidases (eight substrates) and disaccharidases (five substrates) were studied in 18 subjects with the flat intestinal mucosa pattern seen in celiac disease. On a gluten-free diet, 12 patients improved; the other 6 showed no improvement or an uncertain effect. Thirty-seven persons with histologically verified normal intestinal mucosa served as control subjects for the enzymatic determinations. All enzyme activities were reduced in both the gluten responsive and the nonresponsive celiac group. Peptidyl-proline dipeptidase activities were reduced to about 30% of the mean activities in the control group, the other dipeptidase activities to about 50%. No specific deficiency of any particular dipeptidase activity could be demonstrated. The disaccharidase activities corresponded to 10 to 20% of these in the control group. After gluten-free diet the responsive group showed only slight improvement in the peptidyl-proline dipeptidase, maltase, isomaltase, and sucrase activities, whereas the other dipeptidase activities increased considerably. Trehalase and lactase were unchanged during the observation period.
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