A. Tedeschi

Reliability and usefulness of random fecal α1-antitrypsin concentration: further simplification of the method

The reliability of random fecal alpha 1-antitrypsin (FA-1-AT) concentration has been evaluated by comparing FA-1-AT values on random specimens and on concomitant 24-72 h fecal collections. In order to simplify the method, FA-1-AT data derived from lyophilized fecal samples were compared with those obtained from 37 degrees C heat-dried fecal samples. Random FA-1-AT concentration was assayed in 80 children with various gastrointestinal illnesses and 36 healthy age-matched controls. There was a close relationship between FA-1-AT values obtained from random samples and 1-day or 3-day collections. There was also a significant relationship between FA-1-AT values derived from the two different ways of drying the stools. Mean FA-1-AT values were statistically different when compared to the controls in the following groups of disorders: untreated and after-gluten-challenge celiac disease, post-enteritis syndrome, and cows milk intolerance. The possible meanings of the abnormal FA-1-AT concentration in the various disorders are discussed. We conclude that FA-1-AT is a simple and reliable test for enteric protein loss. The simplification of the method proposed by us should reduce the cost of the test and moreover make it feasible in all laboratories.

Immunohistochemical Localization of Lactoferrin in Duodenojejunal Mucosa From Celiac Children

The immunohistochemical localization of lactoferrin (LF) was investigated in the duodenojejunal mucosa of children with untreated and treated celiac disease and in a control group of children of short stature and of children with postenteritis syndrome. In subtotal villous atrophy, LF was present in all epithelial cells of the luminal surface with a lower degree of positivity in crypts, whereas a variable degree of reactivity for LF was observed in epithelial cells of reconstituted villi and crypts. The LF mucosal distribution, however, was not specific for celiac disease since the LF pattern was similar in untreated celiac disease and also in postenteritis syndrome. Moreover, LF was detectable only in 7 of 18 duodenojejunal juice samples obtained from untreated and treated celiac patients and normal controls, the observed values being irrespective of the mucosal morphological status. We conclude that the immunohistochemical evidence of LF in the enterocyte may derive from an autochthonous production since our histochemical findings cannot be related to the concentration of LF in duodenal juice.

Lectin binding sites in duodeno-jejunal mucosae from coeliac children

SummaryThe distribution pattern of some labelled lectins (WGA, SBA, PNA, DBA, ConA, LCA) has been investigated in small intestinal mucosa of coeliac children (119 cases) and normal (short stature) and pathological (postenteritis syndrome) controls. The oligosaccharide side chains of glycoproteins present in the cytoplasm and in the brush border of enterocytes, goblet cells and luminal crypt surface have been revealed. The most important differences in lectin binding reactivity between coeliac and controls mucosae are discussed.

Scanning Electron Microscopy of Histological Relapse after Gluten‐Challenge in Coeliac Disease

ABSTRACT. The steps of the morphological relapse occurring during gluten‐challenge in coeliac children were for the first time investigated by scanning electron microscopy and compared with the morphological changes observed in untreated and treated coeliac patients, in pathological and normal controls. Some peculiar morphological changes, not reported up to now, were observed in treated and relapsed coeliac patients. No relationship was found among the degrees of mucosal atrophy observed by SEM and the duration of the challenge performed by an uncontrolled ingestion of gluten.