Morphometric studies in duodenal biopsies from patients with coeliac disease: the effect of the steroid fluticasone propionate

Aliment Pharmacol Ther. 1991 Apr;5(2):151-60. doi: 10.1111/j.1365-2036.1991.tb00016.x.

Abstract

Morphometric measurements have been performed on small intestinal biopsy specimens from patients with untreated coeliac disease before and after six weeks oral treatment with a steroid of low systemic bioavailability (fluticasone propionate). Measurements were obtained by point counting and also by a computer-aided measuring system with reference to a constant area of the muscularis mucosa. Fluticasone propionate led to a parallel reduction in the intraepithelial lymphocyte count within the surface (P less than 0.001) and crypt epithelium (P less than 0.01). The intra-epithelial lymphocyte count assessed by reference to constant areas of the muscularis mucosa and surface epithelium were decreased two-fold (P less than 0.01) and seven-fold (P less than 0.001) respectively. Fluticasone propionate treatment also led to significant increases in the absorptive surface epithelium as shown by an increase in the villus:crypt ratio (P less than 0.01), the epithelial cell height (P less than 0.01) and two- to three-fold increases in the area and length of the surface epithelium (P less than 0.001). Short-term fluticasone propionate treatment appears to exert a powerful beneficial effect upon duodenal morphology in patients with coeliac disease. Whether the alterations seen are comparable to a similar period of gluten withdrawal is not yet known.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Androstadienes / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use*
  • Biopsy
  • Celiac Disease / drug therapy
  • Celiac Disease / pathology*
  • Duodenum / pathology*
  • Fluticasone
  • Humans
  • Intestinal Mucosa / pathology
  • Lymphocytes / drug effects
  • Regression Analysis
  • Staining and Labeling

Substances

  • Androstadienes
  • Anti-Inflammatory Agents
  • Fluticasone