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Evaluation of crypt apoptotic bodies and apoptotic indices in pediatric celiac disease by routine staining and H2AX immunostaining
International Journal of Immunopathology and Pharmacology ( IF 3.5 ) Pub Date : 2021-06-17 , DOI: 10.1177/20587384211026791
Sarah Adel Hakim 1 , Dalia Abd El-Kareem 2
Affiliation  

Celiac disease (CD) is an immune-mediated disorder with premature apoptosis occurring along the entire crypt-villous axis. H2AX is the end product of the intrinsic apoptotic pathway. This is the first study to assess apoptotic body counts (ABC) by H&E and apoptotic indices (AI) by immunohistochemistry (IHC) in pediatric CD. The aim of the current study was to evaluate ABC in pediatric patients with CD prior to and following institution of a gluten free diet (GFD). Sixty-three pediatric endoscopic duodenal samples were assessed and divided into three groups. A total of 21 samples from treatment naïve CD patients, 21 from the same patients after instituting a GFD, and 21 from non-celiac patients as a control group. Histopathological evaluation of ABC by H&E, and immunohistochemistry assessment of apoptotic indices (AI) by H2AX antibody were performed. The mean maximum ABC and AI were significantly higher in treatment naïve CD than in GFD and control samples. These values were also significantly higher in treatment naïve Marsh 3C (flat) than in Marsh 1, 2, 3A, and 3B (non-flat) CD cases. GFD samples with persistent flat lesions had significantly higher ABC and AI than GFD non-flat cases. ROC analysis of the mean maximum ABC and AI of treatment naïve CD cases had a statistically significant predictive potential for persistent villous atrophy at a cut-off level ⩾6.61 (P = 0.008) and ⩾105.4 (P = 0.003), respectively. Histopathological evaluation of crypt apoptotic bodies could provide predictive potential for continued villous atrophy following GFD.



中文翻译:

通过常规染色和 H2AX 免疫染色评估小儿乳糜泻的隐窝凋亡小体和凋亡指数

乳糜泻 (CD) 是一种免疫介导的疾病,沿整个隐窝-绒毛轴发生过早凋亡。H2AX 是内在凋亡途径的最终产物。这是第一项通过 H&E 评估凋亡体计数 (ABC) 和通过免疫组织化学 (IHC) 在儿科 CD 中评估凋亡指数 (AI) 的研究。本研究的目的是评估儿童 CD 患者在实施无麸质饮食 (GFD) 之前和之后的 ABC。评估了 63 份儿科内窥镜十二指肠样本并将其分为三组。共有 21 个样本来自未接受治疗的 CD 患者,21 个来自实施 GFD 后的相同患者,21 个来自非乳糜泻患者作为对照组。H&E 对 ABC 的组织病理学评估,并通过 H2AX 抗体对细胞凋亡指数 (AI) 进行免疫组织化学评估。初治 CD 的平均最大 ABC 和 AI 显着高于 GFD 和对照样本。这些值在未经治疗的 Marsh 3C(平坦)中也显着高于 Marsh 1、2、3A 和 3B(非平坦)CD 病例。具有持续扁平病变的 GFD 样本的 ABC 和 AI 显着高于 GFD 非扁平病例。对初治 CD 病例的平均最大 ABC 和 AI 的 ROC 分析对持续性绒毛萎缩具有统计学意义的预测潜力,临界值 6.61 ( 和 3B(非平面)CD 盒。具有持续扁平病变的 GFD 样本的 ABC 和 AI 显着高于 GFD 非扁平病例。对初治 CD 病例的平均最大 ABC 和 AI 的 ROC 分析对持续性绒毛萎缩具有统计学意义的预测潜力,临界值 6.61 ( 和 3B(非平面)CD 盒。具有持续扁平病变的 GFD 样本的 ABC 和 AI 显着高于 GFD 非扁平病例。对初治 CD 病例的平均最大 ABC 和 AI 的 ROC 分析对持续性绒毛萎缩具有统计学意义的预测潜力,临界值 6.61 (P  = 0.008)和105.4(P  = 0.003),分别。隐窝凋亡小体的组织病理学评估可以为 GFD 后持续的绒毛萎缩提供预测潜力。

更新日期:2021-06-17
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