Influence of cow's milk proteins and gluten on human duodenal mucosa in organ culture

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 11; no. 4; pp. 481 - 488
• Main Authors: Fluge, G. (University Hospital of Bergen, Bergen, Norway), Aksnes, L
• Format: Journal Article
• Language: English
• Published: United States Lippincott-Raven Publishers 01.11.1990
• Subjects: Adolescent; Adult; Atrophy; Biopsy; BLE; Celiac disease; Celiac Disease - complications; Celiac Disease - pathology; CELIAC SYNDROME; Child; Child, Preschool; CHILDREN; Cow's milk protein intolerance; CULTIVO DE ORGANOS; CULTURE D'ORGANE; DIGESTIVE DISORDERS; Duodenum - drug effects; Duodenum - pathology; ENFANT; ERITROCITOS; ERYTHROCYTE; ERYTHROCYTES; GLUTEN; Glutens - pharmacology; Humans; HYPERSENSITIVITY; Infant; Intestinal Mucosa - drug effects; Lactose Intolerance - complications; Lactose Intolerance - pathology; Microvilli - pathology; MILK PROTEINS; Milk Proteins - pharmacology; NINOS; ORGAN CULTURE; Organ Culture Techniques; PROTEIN INTOLERANCE; PROTEIN METABOLISM DISORDERS; PROTEINAS DE LA LECHE; PROTEINE DU LAIT; REACCIONES ALERGICAS; REACTION ALLERGIQUE; SINTOMAS; SYMPTOME; SYMPTOMS; TRASTORNOS DIGESTIVOS; TRASTORNOS METABOLISMO PROTEICO; TRIGO; TROUBLE DIGESTIF; TROUBLE DU METABOLISME PROTEIQUE; WHEATS
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.1990.tb10153.x

Forty‐five duodenal biopsies from 33 children and 3 adult patients were maintained in organ culture for 24 h and exposed to various cow's milk proteins and gluten. In 10 of 11 celiac patients with a flat duodenal mu‐cosa, and in 2 of 4 patients with partial villous atrophy, a significant reduction in the mean enterocyte height was found after in vitro gluten exposure, compared to culture in basic culture medium. Three patients had coexisting celiac disease and cow's milk protein intolerance. α‐Lactalbumin and β‐lactoglobulin exhibited toxic effects on flat biopsies from two of these patients, and casein was toxic in one. In 10 patients with cow's milk protein intolerance, a significant reduction in enterocyte height was noted in one case with gluten, and in three patients with casein and lactoglobulin, whereas lactalbumin did not affect the tissues. In seven control patients having a normal duodenal mucosa, no in vitro influences were noted, whereas in four patients with partial villous atrophy, a toxic reaction to gluten was seen in one and a reduced enterocyte height was seen after lactoglobulin exposure in another. In vitro toxicity induced by gluten corresponded well with the diagnosis of celiac disease, whereas toxic reactions to cow's milk proteins during organ culture were inconsistent in cow's milk intolerance, except for cases in which a marked enteropathy was documented.