@dbernardo-gut.bsky.social @uva-es.bsky.social @aegastro @sepdigestiva @seeceliaca @celiacscat @CeliacosMadrid @FACEceliacos @infoceliaco @CIBER_ISCIII

9/9💡 Clinical message:
Negative antibodies ≠ mucosal healing.
New biomarkers are needed to monitor mucosal recovery in celiac disease.
🔗 Read the full paper: doi.org/10.1093/cei/...

8/9 Key takeaway:
📍 A strict GFD normalizes duodenal immune balance but not necessarily mucosal structure.
📍 IEL–epithelium interactions (esp. γδ T cells) may sustain the residual damage.

7/9 Duration of the gluten-free diet correlated with:
⬆ Gut-homing markers (α4β7, CCR9, CCR2)
⬆ Effector T cells
⬇ Regulatory T cells
➡ Longer GFD = progressive immune normalization, even if mucosal healing lags behind.

6/9 So, while the tissue architecture remained damaged, the immune environment of the lamina propria was restored.
This suggests that persistent atrophy may originate from the epithelial layer, not from immune cells in the lamina propria.

5/9 Surprisingly, after >1 year on a GFD (average 7 years):
⚪ Serology was negative
⚪ 68% still had villous atrophy
⚪ Yet — the lamina propria immune infiltrate looked normal, nearly identical to controls

4/9 At diagnosis, CD patients had:
🔸 Expansion of NK, ILC, B, Treg and Tγδ cells
🔸 Reduced CD4+ and CD8+ T cells
🔸 Strong pro-inflammatory phenotype (↑ Fas, CD38, CD2)
Classic picture of active mucosal inflammation.

3/9 Researchers from Valladolid (Spain) analyzed duodenal biopsies from:
🔹 6 controls
🔹 6 newly diagnosed CD patients
🔹 19 GFD-treated CD patients
Using spectral flow cytometry, they mapped >70 immune cell subsets in the duodenal mucosa.

2/9 Celiac disease (CD) affects ~1% of the population.
Even after years on a strict gluten-free diet (GFD), many patients still show intestinal villous atrophy — but the reasons remain unclear.

5/ Want to learn more?
📖 Read the full study here: www.mdpi.com/1422-0067/26...
💬 Let’s discuss: What should be the gold standard for a healthy gut mucosa?
#Gastroenterology #Immunology #collaborativeresearch

4/ Why does this matter?
🔹 Our study sets a “gold standard” for the normal histology of the upper digestive tract.
🔹 The immune profile of a truly healthy duodenum should guide future research and diagnostics.

3/ Key findings:
✅ Healthy individuals had lower duodenal intraepithelial lymphocyte (IEL) counts than patients with gastroesophageal reflux disease (GERD) (15 vs. 19.5 per 100 enterocytes, p = 0.004).
✅ CD4+ T cells decreased (p = 0.008) & CD8+ T cells increased (p = 0.014) in GERD.

2/ Most studies lack true healthy controls when investigating inflammatory diseases of the upper gastrointestinal tract. We rigorously selected asymptomatic individuals to establish a reference for future research.
🔬 #GutHealth #CeliacDisease #Endoscopy

Leishmania 🦠 in patients with IBD 🤒 doesn't seem to follow a complicated clinical course, even in those with localized cutaneous leishmania who do not discontinue biological therapy 💉💊 after infection diagnosis.