Citations 2
Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
Rostami, Kamran , Ensarı, Arzu , Marsh, Michael N. , Villanacci, Vincenzo , Aghdaei, Hamid Asadzadeh , Bai, Julio C. , Bassotti, Gabrio , Becheanu, Gabriel , Bell, Phoenix , Bella, Camillo Di, Bozzola, Anna, Cadei, Moris, Casella, Giovanni , Ciacci, Carolina , Ciobanu, Delia , Danciu, Mihai , Das, Prasenjit , Drage, Michael G. , Elli, Luca , Fasano, Alessio , Florena, Ada Maria , Fusco, Nicola , Guandalini, Stefano , Hayman, David T. S. , Ishaq, Sauid , Jericho, Hilary , Johncilla, Melanie , Johnson, Matt, Kaukinen, Katri , Levene, Adam, Liptrot, Sarah, Lu, Laura , Makharia, Govind , Mathews, Sherly, Mazzarella, Giuseppe , Maxim, Roxana, Myint, Khun La Win, Shalmani, Hamid Mohaghegh , Moradi, Afshin , Mulder, Chris J. , Ray, Ronnie, Ricci, Chiara , Rostami‐Nejad, Mohammad , Sapone, Anna, Sanders, David S. , Taavela, Juha , Volta, Umberto , Walker, Marjorie M. , Carroccio, Antonio , Asadzadeh Aghdaei, Hamid , Bassotti, Gabrio , Bell, Phoenix , Casella, Giovanni , Ciacci, Carolina , Apostol Ciobanu, Delia Gabriela , Danciu, Mihai , Das, Prasenjit , Elli, Luca , Fasano, Alessio , Fusco, Nicola , Guandalini, Stefano , Hagen, Catherine E. , Hayman, David T S , Makharia, Govind K , Mazzarella, Giuseppe , Mohaghegh-Shalmani, Hamid , Ricci, Chiara , Rostami-Nejad, Mohammad , Taavela, Juha , Volta, Umberto , Walker, Marjorie , Drage, Michael G , Srivastava, Amitabh , Catassi, Carlo , Cross, Simon S. , SORDO, Rachele DEL , Going, James J. , Derakhshan, Mohammad Hossein
Nutrients | June 16, 2022 | Volume: 14 | Issue: 12 | Pages: 2487
Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 control cases with normal gastroscopy and histologic findings, 261 CeD, and 175 NCGS biopsies from 9 contributing countries were examined. Villus height (VH, in μm), crypt depth (CrD, in μm), villus-to-crypt ratios (VCR), IELs (intraepithelial lymphocytes/100 enterocytes), and other relevant histological, serologic, and demographic parameters were quantified. Results: The median VH in NCGS was significantly shorter (600, IQR: 400–705) than controls (900, IQR: 667–1112) (p < 0.001). NCGS patients with Marsh I-II had similar VH and VCR to CeD [465 µm (IQR: 390–620) vs. 427 µm (IQR: 348–569, p = 0·176)]. The VCR in NCGS with Marsh 0 was lower than controls (p < 0.001). The median IEL in NCGS with Marsh 0 was higher than controls (23.0 vs. 13.7, p < 0.001). To distinguish Marsh 0 NCGS from controls, an IEL cut-off of 14 showed 79% sensitivity and 55% specificity. IEL densities in Marsh I-II NCGS and CeD groups were similar. Conclusion: NCGS duodenal mucosa exhibits distinctive changes consistent with an intestinal response to luminal antigens, even at the Marsh 0 stage of villus architecture.
Gastric pyloric gland adenoma: a multicentre clinicopathological study of 67 cases
Choi, Won‐Tak , Brown, Ian , Ushiku, Tetsuo , Yozu, Masato , Setia, Namrata , Srivastava, Amitabh , Johncilla, Melanie , Pai, Rish K. , Fukayama, Masashi , Misdraji, Joseph , Lauwers, Gregory Y. , Brown, Ian S , Gill, Ryan M. , Srivastava, Amitabh
Histopathology | December 26, 2017 | Volume: 72 | Issue: 6 | Pages: 1007-1014
AimsThere is limited information regarding the clinicopathological and immunohistochemical characteristics of gastric pyloric gland adenomas (PGAs).Methods and resultsSixty‐seven cases of gastric PGA from 57 patients were analysed. PGAs occurred with similar frequency in men and women (47.4 and 52.6%, respectively), with a mean age of 66 years. Most presented in the gastric body/fundus (67.2%). Fifteen cases (22.4%) developed against a background of autoimmune gastritis (AIG), whereas normal mucosa was seen in 35.8%. Only 16.4% (11 cases) developed in patients with a genetic predisposition, most commonly familial adenomatous polyposis. Low‐grade lesions had a mean size of 1.5 cm, while PGAs with high‐grade dysplasia (HGD) or adenocarcinoma had a mean size of 3.5 cm (P < 0.001) and more commonly showed tubulovillous architecture (50.0 versus 25.6% in low‐grade dysplasia; P = 0.040). Most PGAs (61.2%) co‐expressed mucin (MUC)5AC and MUC6 (mixed type), which was associated significantly with HGD or adenocarcinoma (P = 0.013). AIG was also associated with HGD (P = 0.027), but genetic predisposition did not correlate with the grade of dysplasia (P = 0.793). The recurrence rate of PGA was similar for high‐ (11.8%) and low‐grade lesions (7.4%) (P = 0.624).ConclusionsThe risk of HGD increases with the size of PGA, tubulovillous architecture and the presence of AIG as well as mixed immunophenotype. As the overall local recurrence rate is less than 10%, PGAs may be treated conservatively, but they should be excised completely if possible, particularly if they are large or show high‐grade features.