OBSERVATIONS OF THE TIME-COURSE OF THE INFLAMMATORY RESPONSE OF RECTAL MUCOSA TO GLIADIN CHALLENGE IN GLUTEN-SENSITIVE SUBJECTS

Expression of endothelial adhesion molecules is a key factor in locali zing inflammatory processes. We have evaluated the time-course express ion of E-selectin, ICAM-1, and VCAM-1 in rectal mucosae from coeliac p atients (CD) with T-lymphocyte sensitization to wheat (gliadin) protei n. Ten treated, eight untreated CD patients and five disease controls underwent a dynamic 4h rectal gluten challenge. Seven treated CD patie nts had a 24 h challenge to evaluate the time-course changes. Coeliac tissue significantly increased VCAM-1 expression [p < 0.001 (untreated and treated CD)] and E-selectin [p = 0.01 (untreated CD only)]-expres sion compared to controls but not ICAM-1. VCAM-1 continued to increase up to 24h, while E-selectin decreased after 4 h. These findings relat e to an 8 h rise in CD3 (+) lymphocytes [p < 0.05 (treated)] and a 4 h rise in neutrophils (p < 0.005). This approach permits a novel study of the inflammatory response to a known immunogen in human patients.