Francesco Carpino

Duodenal bulb biopsies in celiac disease: a multicenter study

Objectives: Celiac disease (CD)–related lesions have been reported in duodenal bulb biopsies, sometimes the bulb mucosa being the only one affected. The aim was to verify in a significant series whether histological lesions are always present in the bulb of celiac patients, what is the prevalence of lesions when isolated to the bulb, and if similar lesions are present in nonceliac subjects. Methods: We studied 665 children with CD (241 males, range 9 months–15 years, 8 months), at diagnosis on a gluten-containing diet, and 348 age- and sex-matched gastroenterological controls submitted to upper endoscopy for gastroenterological complaints. During endoscopy, multiple biopsies (1 bulb and 4 distal duodenum samples) were taken. Anti-endomysium antibodies were evaluated by immunofluorescence method, anti–human tissue–transglutaminase antibodies by an enzyme-linked immunosorbent assay or radioimmunoassay. Human leukocyte antigen-DRB1, -DQA1, and -DQB1 genes were typed by polymerase chain reaction sequence–specific primers repeat method. Results: In all of the patients with CD, histological lesions were present in the bulb sample; in 16 of them, the lesions were present only in the bulb. Patchy villous atrophy was found in 20 children. All of the patients with CD were anti-endomysium and/or anti-transglutaminase positive. The controls showed neither autoantibody positivity nor mucosal changes compatible with CD. Conclusions: This study demonstrated that CD-related histological lesions are always present in the bulb; sometimes this specific site is the only one affected. Therefore, we suggest taking 2 biopsies from the bulb and 2 from the distal duodenum for CD diagnosis.

Central effects of selective NK1 and NK3 tachykinin receptor agonists on two models of experimentally-induced colitis in rats.

Peripheral tachykinins (TKs) are believed to play a role in the pathogenesis of inflammatory bowel diseases (IBD). In this study we investigated changes induced by central administration of two natural TK receptor agonists, NK(1) (PG-SPI) and NK(3) (PG-KII), on trinitrobenzene sulphonic acid (TNBS)- and dextran sodium sulphate (DSS)-induced experimental colitis in rats. Colitis was induced by instilling a single intracolonic dose of TNBS 50 mgkg(-1) (0.5 ml in 50% ethanol) or by oral administration of 5% DSS for 7 days. Each group of rats was intracerebroventricularly injected daily with PG-SPI and PG-KII (0.5, 5, and 50 microgkg(-1)). On day 3, TNBS-treated animals were killed and the severity of gut inflammation was evaluated by measuring myeloperoxidase (MPO) activity, interleukin-1beta (IL-1beta) production and by scoring macroscopic and histologic colonic damage. DSS-treated animals were checked daily for the length of survival and for stool consistency and faecal blood. In the TNBS group, PG-SPI and PG-KII increased scores for the severity of colonic damage, stimulated the production of IL-1beta and increased granulocyte infiltration into the colon (MPO activity). In the DSS group, PG-SPI and PG-KII decreased the percentage of surviving animals, and increased the number of rats that developed loose stools and blood in the faeces and the MPO activity. These results indicate that centrally injected NK(1) and NK(3) tachykinin receptor agonists play a proinflammatory role in experimentally-induced colitis in rats.

Helicobacter pylori duodenal colonization in children

To investigate the prevalence and the significance of Helicobacter pylori duodenal colonization, endoscopic duodenal biopsies were performed in 168 children with chronic abdominal pain, gastroesophageal reflux, gastrointestinal bleeding, and malabsorption syndrome. Helicobacter pylori infection was detected in 68 children (40.4%): in 31 of them H. pylori was present in the gastric antrum, and in 37 in the duodenum also. Duodenitis was observed in 25 children with duodenal H. pylori; gastric metaplasia in 3. Scanning electron microscopy revealed the presence of the micro‐organism in 3/13 cases; the bacteria were located in the intercellular spaces and alterations of the epithelial surface were found. In conclusion, H. pylori gastritis in children is often associated with duodenal colonization which can cause duodenitis, and also without gastric metaplasia, which indicates a possible role of the micro‐organism in the pathogenesis of the lesions.

Morphological and statistical investigation of the occurrence of 'tubule-like cells' in the renal corpuscle of the mouse kidney induced by sex hormones.

In this report the authors describe the structural and ultrastructural characteristics of some cells constituting the parietal layer of Bowmans capsule of the mouse kidney, which are very similar to the epithelial cells of the proximal convoluted tubule (tubule-like cells). These elements are noted in mature and immature mice of both sexes, but their fine morphology and statistical incidence seem related to the sex and the age of the mice, as revealed by the different responsiveness of the same animals to sex hormones experimentally administered. Such substances, directly and/or through an influence on gonadotropins (especially luteinizing hormone), are able to modify (mainly increasing) the percentage of renal corpuscles possessing tubule-like cells.

Ultrastructural characteristics of idiopathic spermatidic arrest.

Previous studies on some cases of idiopathic spermatidic arrest showed an anomaly in glucose metabolism, in particular decreased utilization of glycogen at stage 3 of spermatogenesis, when condensation of the spermatid head commences. Histological patterns seen on light microscopy confirmed the reduced utilization of glycogen at stage 3 of spermatogenesis. Electron microscopy revealed an arrest at stage 3 of spermiogenesis and, at the cytoplasm level of the Sertoli cell, a modification in the smooth endoplasmic reticulum characterized by the presence of dilated cisternae. From a morphological viewpoint, the equivalent of a biochemical modification which characterizes this maturation disorder in the germinal epithelium is hypothesized.

Scanning Electron Microscopy of Jejunal Biopsies in Patients with Untreated and Treated Coeliac Disease

ABSTRACT. Biopsy specimens of jejunal mucosa from children with coeliac disease (CD) were examined by scanning electron microscopy (SEM) and light microscopy (LM) before and after gluten‐free diet. The results demonstrate that SEM is more sensitive than LM in documenting early morphological restoration of jejunal mucosa in patients treated with gluten‐free diet.

Columnar cells of the parietal layer of Bowman's capsule and their relationship with the sexual cycle in normal female mice

The tubule-like cells (TLC) are present also in the parietal layer of the Bowmans capsule of the renal corpuscles in normal female mice kidney. These cells are morphologically similar to the cells of the proximal convoluted tubule. Further, significant variations of the TLC were present according to the phase of the sexual cycle.

Myosin-like microfilaments in the human normal and pathological testis

The immunofluorescent staining of the human normal testis shows that both peritubular and tubular cells bind antimyosin-like antibodies. The same cells are provided with a large amount of microfilaments within the cytoplasm. The thin microfilaments observed by electron microscopy in various cells of the human testis likely correspond to the sites of immunofluorescent staining. In pathological specimens there can be observed a decrease in peritubular smooth muscle cells associated with a decrease in cytoplasmic microfilaments and in the immunofluorescent staining of some cells.