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- Title
Lymphonodular hyperplasia of the terminal ileum associated with colitis shows an increased γδ<sup>+</sup> T-cell density in children
- Authors
Kokkonen, Jorma; Ruuska, Tarja; Karttunen, Tuomo J.; Mäki, Markku
- Abstract
OBJECTIVE:Recently we reported a close association between lymphonodular hyperplasia (LNH) of the bulb of the duodenum and increased densities of intraepithelial γδ+ T-cells in subjects with untreated food allergies. In this study we sought to determine whether children with LNH of the terminal ileum (TI) show a similar correlation.METHODS:The mucosal specimens taken by colonoscopy from the TIs of 22 children with LNH of the TI without colitis, 13 with right-sided colitis or pancolitis, nine with left-sided colitis, eight with Crohn’s disease, and three endoscopically healthy subjects were studied for T-cell subsets with monoclonal antibodies using a three-layer peroxidase staining method.RESULTS:LNH of the TI was found in 32 of the 55 subjects (58%). In 22 it was the only endoscopic finding, but in nine of 13 subjects (69%) it was related to right-sided colitis or pancolitis. In patients with left-sided colitis or Crohn’s disease it was diagnosed only rarely. In the whole study population, LNH of the TI showed a significant association with the increment in the density of γδ+ T-cells. The subjects with LNH of the TI and colitis starting from the cecum showed the highest values, discriminating them statistically from any other study group. Accordingly their γδ+/CD3+ ratio was high. Even in the subjects with LNH of the TI without colitis, the increment in γδ+ T-cells was significant as compared with the subjects with left-sided colitis. Upregulations of D-related expression on the mucosa of the TI were similar regardless of the presence of LNH or colitis or an increment in γδ+ T-cells.CONCLUSION:Our preliminary observations showed increased densities of intraepithelial γδ+ T-cells and elevated γδ+/CD3+ ratios in subjects with LNH on the mucosa of the TI, especially if related to colitis starting at the cecum, but not in subjects with typical left-sided colitis or granulomatous Crohn’s disease. The study also provides further evidence suggesting the significance of food-borne antigens in the pathogenetic mechanism of right-sided colitis or pancolitis. The finding also indicates the significance of classifying colitis into γδ-positive and -negative diseases, and has implications for the treatment of these entities.
- Publication
American Journal of Gastroenterology (Springer Nature), 2002, Vol 97, Issue 3, p667
- ISSN
0002-9270
- Publication type
Academic Journal
- DOI
10.1111/j.1572-0241.2002.05547.x