T-bet expression patterns in coeliac disease, cryptic and overt enteropathy-type T-cell lymphoma

Histopathology. 2005 Oct;47(4):368-74. doi: 10.1111/j.1365-2559.2005.02237.x.


Aims: To clarify the distribution and lineage allocation of T-bet-expressing cells in coeliac disease (CD) and in enteropathy-type T-cell lymphoma (ETTCL). The detection of elevated levels of interferon-gamma, interleukin-18 and the key regulator of Th1 helper immune response T-bet in CD biopsies led to the view that CD is the result of a Th1 response to gluten. It remains unknown whether T-bet is expressed in cryptic and overt ETTCL.

Methods: Specimens from 20 patients with CD, five patients with cryptic and 10 patients with overt ETTCL were analysed by immunohistology employing single and double labellings for T-bet and CD4 or CD8 antigens.

Results: In CD specimens nearly all intraepithelial CD8 cells and many CD4 cells in the lamina propria expressed T-bet. Cryptic ETTCL showed T-bet expression in the intraepithelial neoplastic cells while T-bet+ CD4 cells in the lamina propria were rare. Overt ETTCL showed T-bet expression in cases with non-anaplastic morphology. In addition, a proportion of bystander T cells expressed T-bet.

Conclusions: Morphological evidence proves that while T-bet orchestrates a CD4- and CD8-based Th1 reaction in CD, its expression shifts to the neoplastic intraepithelial compartment of cryptic ETTCL and becomes absent or lost in anaplastic overt ETTCL.

MeSH terms

  • CD4 Antigens / biosynthesis
  • CD8 Antigens / biosynthesis
  • Celiac Disease / metabolism*
  • Celiac Disease / pathology
  • Humans
  • Immunohistochemistry
  • Intestinal Neoplasms / metabolism*
  • Intestinal Neoplasms / pathology
  • Lymphoma, T-Cell / metabolism*
  • Lymphoma, T-Cell / pathology
  • Polymerase Chain Reaction
  • T-Box Domain Proteins
  • Transcription Factors / biosynthesis*


  • CD4 Antigens
  • CD8 Antigens
  • T-Box Domain Proteins
  • T-box transcription factor TBX21
  • Transcription Factors