In vitro-deranged intestinal immune response to gliadin in type 1 diabetes

Diabetes. 2004 Jul;53(7):1680-3. doi: 10.2337/diabetes.53.7.1680.


Dietary gluten has been associated with an increased risk of type 1 diabetes. We have evaluated inflammation and the mucosal immune response to gliadin in the jejunum of patients with type 1 diabetes. Small intestinal biopsies from 17 children with type 1 diabetes without serological markers of celiac disease and from 50 age-matched control subjects were examined by immunohistochemistry. In addition, biopsies from 12 type 1 diabetic patients and 8 control subjects were cultured with gliadin or ovalbumin peptic-tryptic digest and examined for epithelial infiltration and lamina propria T-cell activation. The density of intraepithelial CD3(+) and gammadelta(+) cells and of lamina propria CD25(+) mononuclear cells was higher in jejunal biopsies from type 1 diabetic patients versus control subjects. In the patients' biopsies cultured with peptic-tryptic gliadin, there was epithelial infiltration by CD3(+) cells, a significant increase in lamina propria CD25(+) and CD80(+) cells and enhanced expression of lamina propria CD54 and crypt HLA-DR. No such phenomena were observed in control subjects, even those with celiac disease-associated HLA haplotypes. In conclusion, signs of mucosal inflammation were present in jejunal biopsies from type 1 diabetic patients, and organ culture studies indicate a deranged mucosal immune response to gliadin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antibody Formation
  • Biopsy
  • Case-Control Studies
  • Child
  • Diabetes Mellitus, Type 1 / immunology*
  • Female
  • Gliadin / immunology*
  • HLA Antigens / analysis
  • HLA Antigens / classification
  • Humans
  • Immunohistochemistry
  • Intestinal Mucosa / immunology*
  • Jejunum / immunology
  • Jejunum / pathology
  • Male
  • Organ Culture Techniques


  • HLA Antigens
  • Gliadin