Cellular and humoral sensitivity to gluten fractions in patients with treated nontropical sprue

Abstract

The presence of circulating antibodies and lymphocyte response to gliadin and fraction III were measured in three groups of 12 patients each. Group I consisted of patients with nontropical sprue maintained on a gluten-free diet; Group II contained patients with other gastrointestinal diseases manifesting malabsorption and Group III was composed of normal controls. Rabbits immunized to both antigens provided positive controls for each method of antibody determination. Results agree with those previously reported in that negligible antibody titers were present to either antigen in normals, patients with other forms of malabsorption or patients with nontropical sprue maintained, for some time, on a gluten-free diet. Lymphocyte stimulation failed to occur with either gluten fraction although the hyporesponsiveness to phytohemagglutinin, previously reported by others, was not observed. Further studies are needed in patients with nontropical sprue following controlled antigenic challenge. Antibody levels in jejunal fluid should also be studied. Until such studies are carried out, evaluation of immunologic factors in the pathogenesis of nontropical sprue will be incomplete.