ORIGINAL ARTICLE

Basement membrane and connective tissue proteins in intestinal mucosa of patients with coeliac disease

S Verbeke¹, M Gotteland¹, M Fernández², J Bremer⁴, G Ríos³, O Brunser¹

¹ Gastroenterology Unit, Human Nutrition Division, Institute of Nutrition and Food Technology, J.P. Alessandri 5540, Santiago, Chile
² Cell Biology Division, Institute of Nutrition and Food Technology
³ Department of Pediatrics, Hospital Exequiel González Cortéz, Damón Subercaseaux 1528, Santiago, Chile
⁴ Medical School, University of Leiden, The Netherlands

Correspondence to:
Correspondence to:
Dr O Brunser, Gastroenterology Unit, Institute of Nutrition and Food Technology, University of Chile, Casilla 138–11, Santiago, Chile;
brunser{at}entelchile.net

Aims: Gluten ingestion in coeliac disease is associated with alterations of the intestinal mucosa, especially the expansion of the lamina propria. Antiendomysium and antireticulin antibodies may result from interactions between gliadin and extracellular matrix components. By behaving as autoantigens, connective tissue proteins could initiate mucosal damage. This study evaluates changes in the distribution of laminin, type IV collagen, and fibronectin in the mucosa of patients with coeliac disease in an attempt to explain the alterations of mucosal morphology.

Methods: Intestinal biopsies were obtained from patients with coeliac disease on admission and while on a gluten free diet. The distribution of type IV collagen, laminin, fibronectin, and -smooth muscle actin was evaluated by immunofluorescence and by immunogold labelling and electron microscopy.

Results: In patients with coeliac disease, the intensity of type IV collagen, laminin, and fibronectin immunofluorescent staining was decreased and less well defined than in controls, with frequent breaches in the basement membrane; fibronectin staining was weak in the distal third of the elongated crypts and absent under the flat surface. The distribution of smooth muscle fibre in the distal lamina propria of flat mucosae was altered. The distribution of these proteins was normal as assessed by immunoelectron microscopy.

Conclusions: The intensity of staining of some components of the basement membrane is decreased in coeliac disease and the distribution of smooth muscle fibres is altered. These changes may result from interactions between gliadin and components of the extracellular matrix and may play a role in the genesis of mucosal lesions and in the damage to the epithelium.

Keywords: coeliac disease; laminin; fibronectin; type IV collagen

Abbreviations: FITC, fluorescein isothiocyanate; SMA, -smooth muscle actin; tTG, tissue transglutaminase

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