The level of auto-antibodies to the enzyme transglutaminase 2 (TG2) and gliadin in gluten-consuming subjects are used as a diagnostic adjunct and marker of disease activity. DCs isolated from patients with active celiac disease behave as APCs and transcribe IFN-gamma 9, a key cytokine in the pathogenesis of CeD. Histopathological studies demonstrate villous atrophy with defective transepithelial 5, 6 and paracellular uptake of gliadin by the intestinal mucosa of patients with active celiac disease.Ĭirculating dendritic cells are recruited to the inflamed mucosa in those with active CeD, and indeed, there is a significant increase in the number of dendritic cells (DC) in the lamina propria of patients with active celiac disease, which reverts to normal with a gluten-free diet 7, 8. It is characterized by varying degrees of intestinal malabsorption, caused by an inappropriate immune response to ingested wheat gluten containing gliadin. However, the correlation between corneal LC density and anti-TtG levels suggests a relationship with disease activity in CeD and requires further study.Ĭeliac disease (CeD) affects ~ 0.7% of the world population 1, but may be more prevalent in the Middle East 2, 3, especially in Qatar 4. There was no difference in corneal LC density between children with CeD and controls. Immature (r = 0.602, P = 0.038) and total (r = 0.637, P = 0.026) LC density also correlated with tissue transglutaminase antibody (Anti-TtG) levels assessed in 12/20 subjects with CeD. 1.56(1.04–8.33) P = 0.752) LC density did not differ between the CeD and control groups. 59.77 ± 22.45 P = 0.014) were significantly lower in children with CeD compared to controls. There was no difference in age (11.78 ± 1.7 vs. Twenty children with stable CeD and 20 age-matched controls underwent CCM and quantification of central corneal total, mature and immature LC density. This study aims to establish if quantification of corneal Langerhans cells (LCs) using corneal confocal microscopy (CCM) could act as a surrogate marker for antigen presenting cell status and hence disease activity in children with CeD. Celiac disease (CeD) is a common small bowel enteropathy characterized by an altered adaptive immune system and increased mucosal antigen presenting cells.
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