Histopathological findings in the oral mucosa of celiac patients.

Background: Celiac disease (CD) is an immune-mediated
enteropathy triggered by the ingestion of gluten in genetically
susceptible subjects. Although the small intestinal mucosa is the
main site of the gut’s involvement in CD, other mucosal surfaces
belonging to the gastrointestinal tract and the gut-associated
lymphoid tissue are known to be affected.
Aim: Assuming that the oral mucosa could reflect the
histopathological inflammatory alterations of the intestine in CD
patients, this study wishes to assess the pattern of T-cell subsets in
the oral mucosa of young adults with CD.
Methods: A group of 37 patients (age range 20-38 years;
female: male ratio 28:9) with CD were enrolled. Out of 37 patients,
19 patients (group A) followed a gluten free diet (GFD) -2 patients
from less than one year; 6 patients between 1 and 5 years; 11
patients more than 5 years- while 18 patients (group B) were still
untreated. Fifteen healthy volunteers (age range 18-35 years,
female: Male ratio 11:4) served as controls for the CD patients.
Ethical approval for the research was granted by the Ethics
Committee. Biopsy specimens were taken from normal looking oral
mucosa. The immunohistochemical investigation was performed
with monoclonal antibodies to CD3, CD4, CD8, and γδ-chains T
cell receptor (TCR).
Results: The T-lymphocytic inflammatory infiltrate was
significantly (p < 0.0001) increased in group B (both compared
with group A and with the control group).
Conclusion: This study confirms the oral cavity to be a site
of involvement of CD and its possible diagnostic potentiality in this disease.