Anti-TCR gamma antibody in celiac disease: the value of count on formalin-fixed paraffin-embedded biopsies

Virchows Arch. 2013 Sep;463(3):409-13. doi: 10.1007/s00428-013-1448-7. Epub 2013 Jul 17.

Abstract

Small bowel intraepithelial lymphocytosis (IL) may depend from different causes, including celiac disease (CD). Demonstration of increased number of duodenal T cell receptor gamma-delta (TCRγδ) positive intraepithelial lymphocytes (IELs) has been used to support CD diagnosis on frozen material. This work evaluates a new commercially available anti-TCRγ antibody on formalin-fixed paraffin embedded (FFPE) small bowel biopsies. Anti-CD3 and anti-TCR CγM1 (clone γ3.20) from Thermo Scientific were applied by immunohistochemistry on 59 FFPE biopsies from 18 cases of CD with mild/severe atrophy, 19 cases of IL in CD patients on gluten-free diet (IL-GFD), 14 cases of IL (6/14 with positive CD-related serology), and 8 controls (CTR) with mild duodenitis and negative CD serology and genotyping. IELs/100 epithelial cells were counted in at least six high power fields. CD3+ and TCRγ+ IELs were significantly higher in CD, IL-GFD, and IL compared with CTR, but in contrast to CD3+ IELs, TCRγ+ IELs were significantly increased in CD and IL-GFD compared with IL. Furthermore, TCRγ+ IELs discriminated between IL with negative and positive CD-related serology (p = 0.02). TCRγ+ IELs can be identified on FFPE samples and their evaluation adds useful information for the work-up of small bowel biopsies in CD diagnosis. In fact, TCRγ staining coupled with CD3, may represent an additional tool to recognize cases of latent/potential CD when serology and clinical data are not conclusive or when the histological diagnosis remains equivocal.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Anti-Idiotypic* / immunology
  • Biopsy
  • CD3 Complex / immunology
  • CD3 Complex / metabolism
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology
  • Celiac Disease / pathology
  • Child
  • Child, Preschool
  • Duodenum / metabolism
  • Duodenum / pathology*
  • Female
  • Formaldehyde
  • Humans
  • Immunohistochemistry / methods
  • Male
  • Middle Aged
  • Paraffin Embedding
  • Receptors, Antigen, T-Cell, gamma-delta / immunology*
  • Receptors, Antigen, T-Cell, gamma-delta / metabolism
  • Young Adult

Substances

  • Antibodies, Anti-Idiotypic
  • CD3 Complex
  • Receptors, Antigen, T-Cell, gamma-delta
  • Formaldehyde