The Paneth cell population in surgically resected human jejunum and ileum was estimated using image analysis of the granule area in patients who had not received antibiotics. The mucosa was cultured aerobically and anaerobically. In the jejunum 22 samples were sterile and five yielded bacteria; in the ileum four were sterile and three were non-sterile. The mean Paneth cell granule area in the sterile jejunum was 122.7 +/- 37.2 micron2 and in the non-sterile samples 67.2 +/- 36.6 micron2 (p less than 0.006). The corresponding values for the ileum were 137.9 +/- 109.8 and 100.5 +/- 9.1 (NS). Thus an increase in the Paneth cell population may occur in response to changes in the intestinal luminal environment. Failure of this response and resultant Paneth cell deficiency may lead to bacterial overgrowth.
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