Epithelial-Cell Renewal in Cultured Duodenal Biopsies in Celiac Sprue

Abstract

Proliferation and migration of duodenal epithelium was studied in cultured mucosal biopsies from three normal volunteers and from three patients with celiac sprue before and after treatment with a gluten-free diet. The number of epithelial cells incorporating thymidine-³H into nuclei from the culture medium was over twice as great in pretreatment celiac-sprue biopsies as in normal biopsies. This indicates enhanced proliferation in celiac sprue. Labeled cells migrated to the surface epithelium in 24-hour cultures from all untreated patients whereas labeled cells did not migrate beyond the lower third of the villi in the normal volunteers. Surface epithelial cells, which appear damaged in uncultured celiac-sprue biopsies, reverted toward normal after only 24 hours of culture in a gluten-free environment. After six to 15 weeks of gluten withdrawal, cell proliferation and migration in cultured celiac-sprue biopsies were intermediate between pretreatment and normal biopsies. Thus, short-term treatment induces partial reversion of the abnormal epithelial-cell proliferation that characterizes untreated celiac sprue.