Small intestinal enteropathy with epithelial IgG and
complement deposition in children with regressive autism.
Torrente F, Ashwood P, Day R, Machado N, Furlano RI, Anthony A, Davies SE,
Wakefield AJ, Thomson MA, Walker-Smith JA, Murch SH.
Centre for Paediatric Gastroenterology, with the.
We have reported lymphocytic colitis in children with regressive autism, with
epithelial damage prominent. We now compare duodenal biopsies in 25 children
with regressive autism to 11 with coeliac disease, five with cerebral palsy and
mental retardation and 18 histologically normal controls. Immunohistochemistry
was performed for lymphocyte and epithelial lineage and functional markers. We
determined the density of intraepithelial and lamina propria lymphocyte
populations, and studied mucosal immunoglobulin and complement C1q localisation.
Standard histopathology showed increased enterocyte and Paneth cell numbers in
the autistic children. Immunohistochemistry demonstrated increased lymphocyte
infiltration in both epithelium and lamina propria with upregulated crypt cell
proliferation, compared to normal and cerebral palsy controls. Intraepithelial
lymphocytes and lamina propria plasma cells were lower than in coeliac disease,
but lamina propria T cell populations were higher and crypt proliferation
similar. Most strikingly, IgG deposition was seen on the basolateral epithelial
surface in 23/25 autistic children, co-localising with complement C1q. This was
not seen in the other conditions. These findings demonstrate a novel form of
enteropathy in autistic children, in which increases in mucosal lymphocyte
density and crypt cell proliferation occur with epithelial IgG deposition. The
features are suggestive of an autoimmune lesion.
PMID: 11986981 [PubMed - in process]
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