Changing jejunal gamma delta T cell receptor (TCR)-bearing intraepithelial lymphocyte density in coeliac disease.

The function of jejunal intraepithelial gamma delta+ T cells is obscure, but they are commonly implicated as playing a role in inflammatory and autoimmune conditions. In coeliac disease (CoD), there are controversial reports as to gluten dependency of these cells. We have now studied the small bowel mucosal intraepithelial T cell densities, and the ratios of gamma delta+ to CD3+ T cells and gamma delta+ to alpha beta+ T cells during early disease development and on a gluten-free diet. Nine children initially excluded for CoD were followed up and rebiopsy after 0.8-4.5 years showed mucosal deterioration. Further, 21 biopsy specimens from newly diagnosed CoD patients were studied, together with 20 specimens taken from children on a gluten-free diet. During CoD development the density of gamma delta+ and alpha beta+ T cells as well as the ratios of gamma delta+ to CD3+ T cells and gamma delta+ to alpha beta+ T cells increased. In the latent stage of CoD when the small bowel mucosal architecture was still normal, two children had clearly normal densities of gamma delta+ (< 2.5 cells/100 epithelial cells) and alpha beta+ (< 25.0 cells/100 epithelial cells) T cells, and low ratios as well. In patients with newly diagnosed CoD the densities decreased significantly on a long-term gluten-free diet. We conclude that the density of intraepithelial gamma delta+ T cells as well as alphabeta+ T cells in CoD is gluten-dependent. CoD can develop in a child ingesting normal amounts of gluten and having normal jejunal mucosal morphology on biopsy and a normal density of gamma delta+ T cells.     

Dialysable Leukocyte Extracts (Transfer Factor) Augment Nonspecifically Keyhole Limpet Haemocyanin and Horseshoe Crab Haemocyanin Skin Reactivity in Unimmunized Human Recipients

Dialysable leukocyte extracts (DLE) may induce marked changes in the immune expression of human recipients. It is unclear whether the conversion of skin reactivity by DLE is due to a donor-related specific transfer factor or to an antigen nonspecific augmenting factor which enhances a preexisting low-level response in DLE recipients. In this study, DLE from immunized and unimmunized human and calf donors or saline was administered to 88 medical students. The recipient population demonstrated minimal background responses to the test antigens keyhole limpet haemocyanin (KLH) and horseshoe crab haemocyanin (HCH). The results indicate that the DLE preparations from both immunized and unimmunized donors significantly stimulated skin reactivity but not in vitro responses to both KLH and HCH in the recipient population. The results suggest that these DLE preparations contain an immunologically nonspecific augmentor, which stimulates a preexisting low-level response in the unimmunized population to become a clearly observable skin reaction.