NOVEL INSIGHTS INTO HUMAN INTESTINAL EPITHELIAL-CELL PROLIFERATION INHEALTH AND DISEASE USING CONFOCAL MICROSCOPY

Measurement of intestinal epithelial cell proliferation has provided i mportant information concerning tissue responses in neoplasia, enterop athy, and adaptation. This study reexamined current concepts regarding intestinal proliferation by using a novel confocal microscopical tech nique to map mitotic figures accurately within the intact three dimens ional framework of the crypts of Lieberkuhn. The ability of confocal m icroscopy to simultaneously measure crypt morphology and internal deta il, without disrupting spatial cell arrangements, has provided importa nt new data. These question the ability of existing methods to accurat ely measure and interpret proliferative changes in the gut. This work investigates intestinal proliferation in children with coeliac disease , a well defined hyperproliferative disorder, in comparison with the h ealthy intestine. These results show that crypt cell division occurs w ith an equal probability in health and disease. In addition, increased crypt cell production rates are largely caused by a change in crypt s ize rather than a change in cell cycle time or crypt growth fraction a nd, as such, alter our understanding of kinetic responses in gastroint estinal disease.