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. 1979 May;42(5):402–406. doi: 10.1136/jnnp.42.5.402

Morphological and biochemical findings in jejunal biopsies from patients with multiple sclerosis.

P E Jones, C Pallis, T J Peters
PMCID: PMC490226  PMID: 448378

Abstract

Gluten withdrawal from the diet is occasionally used speculatively in the management of multiple sclerosis. To assess whether there might be any rational basis for such a measure we have undertaken morphological and biochemical studies of the jejunal mucosa in 14 patients with multiple sclerosis. All were found to have morphologically normal villi, and quantitative estimation of surface-to-volume ratios gave values which did not differ from control subjects. Intraepithelial lymphocyte counts were normal. Antigliadin antibody titres were not raised in any patient. Estimation of activity of the brush border disaccharidases (sucrase, lactase, and maltase (showed that the mean level of each enzyme did not differ significantly from control subjects. Analytical subcellular fractionation of the biopsies showed no changes in the distribution or activity of marker enzymes for the brush order, lysosomes, mitochondria, cytosol, peroxisomes, or endoplasmic reticulum. It is concluded that there are no gross morphological or biochemical abnormalities in the jejunal mucosa in patients with multiple sclerosis and, therefore, that the use of gluten-free diets cannot be justified on the assumption that these patients suffer from a coeliac-like lesion of the small intestine.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acheson E. D. Epidemiology of multiple sclerosis. Br Med Bull. 1977 Jan;33(1):9–14. doi: 10.1093/oxfordjournals.bmb.a071407. [DOI] [PubMed] [Google Scholar]
  2. BOYDEN S. V. The adsorption of proteins on erythrocytes treated with tannic acid and subsequent hemagglutination by antiprotein sera. J Exp Med. 1951 Feb;93(2):107–120. doi: 10.1084/jem.93.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dunnill M. S., Whitehead R. A method for the quantitation of small intestinal biopsy specimens. J Clin Pathol. 1972 Mar;25(3):243–246. doi: 10.1136/jcp.25.3.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ferguson A., Murray D. Quantitation of intraepithelial lymphocytes in human jejunum. Gut. 1971 Dec;12(12):988–994. doi: 10.1136/gut.12.12.988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fry L., Seah P. P., McMinn R. M., Hoffbrand A. V. Lymphocytic infiltration of epithelium in diagnosis of gluten-sensitive enteropathy. Br Med J. 1972 Aug 12;3(5823):371–374. doi: 10.1136/bmj.3.5823.371. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. GUNTHER M., ASCHAFFENBURG R., MATTHEWS R. H., PARISH W. E., COOMBS R. R. The level of antibodies to the proteins of cow's milk in the serum of normal human infants. Immunology. 1960 Oct;3:296–306. [PMC free article] [PubMed] [Google Scholar]
  7. Jones N. L., Heigenhauser G. F., Campbell E. J. Open-circuit method for measuring carbon dioxide tension in venous blood. Clin Sci Mol Med. 1977 Nov;53(5):503–504. doi: 10.1042/cs0530503. [DOI] [PubMed] [Google Scholar]
  8. Lange L. S., Shiner M. Small-bowel abnormalities in multiple sclerosis. Lancet. 1976 Dec 18;2(7999):1319–1322. doi: 10.1016/s0140-6736(76)91972-3. [DOI] [PubMed] [Google Scholar]
  9. Matheson N. A. Letter: Multiple sclerosis and diet. Lancet. 1974 Oct 5;2(7884):831–831. doi: 10.1016/s0140-6736(74)91087-3. [DOI] [PubMed] [Google Scholar]
  10. Peters T. J. Analytical subcellular fractionation of jejunal biopsy specimens: methodology and characterization of the organelles in normal tissue. Clin Sci Mol Med. 1976 Dec;51(6):557–574. doi: 10.1042/cs0510557. [DOI] [PubMed] [Google Scholar]
  11. Peters T. J., Batt R. M., Heath J. R., Tilleray J. The micro-assay of intestinal disaccharidases. Biochem Med. 1976 Apr;15(2):145–148. doi: 10.1016/0006-2944(76)90041-7. [DOI] [PubMed] [Google Scholar]
  12. Peters T. J., Heath J. R., Wansbrough-Jones M. H., Foe W. F. Enzyme activities and properties of lysosomes and brush borders in jejunal biopsies from control subjects and patients with coeliac disease. Clin Sci Mol Med. 1975 Apr;48(4):259–267. doi: 10.1042/cs0480259. [DOI] [PubMed] [Google Scholar]
  13. Peters T. J., Jones P. E., Wells G. Analytical subcellular fractionation of jejunal biopsy specimens: enzyme activities, organelle pathology and response to gluten withdrawal in patients with coeliac disease. Clin Sci Mol Med. 1978 Sep;55(3):285–292. doi: 10.1042/cs0550285. [DOI] [PubMed] [Google Scholar]
  14. SCHUMACHER G. A., BEEBE G., KIBLER R. F., KURLAND L. T., KURTZKE J. F., MCDOWELL F., NAGLER B., SIBLEY W. A., TOURTELLOTTE W. W., WILLMON T. L. PROBLEMS OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS: REPORT BY THE PANEL ON THE EVALUATION OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS. Ann N Y Acad Sci. 1965 Mar 31;122:552–568. doi: 10.1111/j.1749-6632.1965.tb20235.x. [DOI] [PubMed] [Google Scholar]
  15. SHATIN R. MULTIPLE SCLEROSIS AND GEOGRAPHY. NEW INTERPRETATION OF EPIDEMIOLOGICAL OBSERVATIONS. Neurology. 1964 Apr;14:338–344. doi: 10.1212/wnl.14.4.338. [DOI] [PubMed] [Google Scholar]

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