Browsing by Author "Marsh MN"

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    Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
    (MDPI (Basel, Switzerland), 2022-06-15) Rostami K; Ensari A; Marsh MN; Srivastava A; Villanacci V; Carroccio A; Asadzadeh Aghdaei H; Bai JC; Bassotti G; Becheanu G; Bell P; Di Bella C; Bozzola AM; Cadei M; Casella G; Catassi C; Ciacci C; Apostol Ciobanu DG; Cross SS; Danciu M; Das P; Del Sordo R; Drage M; Elli L; Fasano A; Florena AM; Fusco N; Going JJ; Guandalini S; Hagen CE; Hayman DTS; Ishaq S; Jericho H; Johncilla M; Johnson M; Kaukinen K; Levene A; Liptrot S; Lu L; Makharia GK; Mathews S; Mazzarella G; Maxim R; La Win Myint K; Mohaghegh-Shalmani H; Moradi A; Mulder CJJ; Ray R; Ricci C; Rostami-Nejad M; Sapone A; Sanders DS; Taavela J; Volta U; Walker M; Derakhshan M; Witteman B
    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.