Paucicellular & Asymptomatic LC

harvest_table · Post by **harvest_table** » Wed Oct 25, 2006 3:20 pm

Hi PP.

I'm trying to understand this article, specifically in relation to gluten intolerence. Do you understand that these folks have P-LC or C-LC and were not sensitive to gluten? Need help decifering.

http://www.ajcp.com/previews/abstracts/204071.html

Any comments appreciated. Thanks.

Love,
Joanna

mle_ii · Post by **mle_ii** » Wed Oct 25, 2006 4:33 pm

My guess it's their clumsy way of saying not Celiac Disease. Without the full article I cannot say for sure.

Mike

Post by **tex** » Wed Oct 25, 2006 5:18 pm

What the . . . ? Joanna, you've really come up with something of significance this time.

Way to go!

Here's the full article, (I believe):

http://www.medscape.com/viewarticle/487838_4

If I'm interpreting that article correctly, it says that they took a sample of 38 patients diagnosed with LC, and 100 patients who had no LC diagnosis, and no symptoms, and the researchers found that exactly half of the total sample of 38 diagnosed LC cases, had relatively light cases of inflammation, so they decided to classify them as a paucicellular subset. Okay, that's fine with me, if they want to do that.

The kicker, though, is the fact that of the population of 100 undiagnosed individuals, 26% of then had LC, and were'nt even aware of it. Incredible! They were afraid to even comment on that can of worms.

Love,
Tex

harvest_table · Post by **harvest_table** » Wed Oct 25, 2006 7:29 pm

Yep, that's the article Tex. Thank you!

Significant is right and very very interesting.

In the link you provided I had to log in to Medscape in order to read that. I'm already a registered member but for the benefit of those who don't wish to register but would like to read the article I'd like to cut and paste here some portions of the text. In your opionion, am I walking a thin line by doing that- some copyright thing?

Love,
Joanna

Post by **tex** » Wed Oct 25, 2006 7:54 pm

Yep, copying any part of it would technically be in violation of their copyright notice, especially since they're going to such extremes to prevent viewers from accessing it without signing up.

When I first found it, I didn't have to log in. Give me a little while to see if I can figure out a way around their log in page.

Love,
Tex

Post by **tex** » Wed Oct 25, 2006 8:06 pm

Well, you can view the first page, by Googling the word "paucicellular", and clicking on the first hit in the list, but I can't find a way around signing up, if you want to view the other three pages.

Love,
Tex

mle_ii · Post by **mle_ii** » Wed Oct 25, 2006 8:35 pm

I would assume (ha!) that one could paraphrase and/or quote the good bits without breaking copyright. But I'm sure I'll get access to it soon enough as this has got me very curious.

This whole bit of MC has me wondering if more folks out there would show some of the microscopic aspects of inflammation without all the symptoms and this appears to agree with it.

Boy I sure wish I had a lab to test some of my theories. :)

Mike

harvest_table · Post by **harvest_table** » Wed Oct 25, 2006 8:46 pm

Thanks Tex, I'll look around too and see if I can find the full text someplace else.

Hey Mikey! I wish you had a lab too....register and read the full article and let us know what you think.

Love,
Joanna

harvest_table · Post by **harvest_table** » Thu Oct 26, 2006 11:58 pm

I'm unable to find another link to this entire article to post here.

Mike, you had Dr. Fines tests done and I understand that showed gluten sensitivity only- is that right? What is your diet now, are you avoiding gluten? Do you react to gluten?

Curious, you could possibly be an asymptomatic P-LC that was lucky enough to be diagonosed before classic symptoms manifest.

PM me if your unable to read that article.

Love,
Joanna

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 10:08 am

I'm going to read the article right now.

As far as your other questions. Yes, Dr Fine's tests as well as an IgG test of blood via a different lab. Both showed gluten sensitivity. Dr Fine's tests showed no other sensitivities, but the IgG test showed a low reaction to Whey and Almond. You can check out my journal in the link found in my signature.

Totally avoiding gluten even trying to avoid cross contamination as well as I can. I reacted to gluten in the past, but I've yet to challenge myself since I stopped.

Mike

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 10:32 am

Ok, here's my first thought, I'm going to write them as I think of them so that I don't lose track.

From this quote:

A second group of cases were asymptomatic, non-gluten-sensitive (celiac sprue) patients with LC.

It appears that I was right, that what they mean by non-gluten-sensitive are those diagnosed with Celiac Sprue or Celiac Disease. So that would mean I'm still one of those by the medical gold standard for the definition of Celiac Disease.

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 10:32 am

Another though, just random so take it for what it's worth. But given how I don't seem to digest certain sugars well, and that those sugars require certain enzymes or acidity of stomach or some other mechanism. And given that part of the process of gliadin being seen by the immune system as bad requires gluten to be broken down, perhaps we (those with MC/LC/CC) lack some of the tools (enzymes, acid, whatever) to break the proteins down. Now, what might have those tools that has us reacting (but not reacting as those with Celiac Disease do)? How about bacteria? For example if we lack the enzyme to break down lactose (lactase) then the lactose makes it's way to the colon where it is broken down by the bacteria that can break it down. How about some bacteria being capable of breaking down gluten, exposing the gliadin, where the gliadin is exposed to the colon instead of the small intestine? I know a stretch, but I had to get this out while I was thinking about it. :)

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 11:11 am

Ok, what I also see (that I didn't know before) was that intraepithelial lymphocyte numbers were larger in the Ascending colon than in the Transverse or descending colon or Sigmoid colon or rectum. In fact they decrease in number the closer you get to the rectum. This was found both in the P-LC and C-LC cases. The numbers are 2-3 times larger in C-LC than in P-LC.

What this means I have no idea, but it is rather interesting.

I also wonder if the count was done in my biopsy examination. I don't ever remember a number, but I'll have to ask.

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 12:56 pm

Ok I finished it. Very interesting indeed. I think I need to go back and read the studies of the last few years for MC/LC/CC.

mle_ii · Post by **mle_ii** » Fri Oct 27, 2006 5:47 pm

From a different article, but related to what we're talking about.

Reduced CD1d Expression in Colonic Epithelium
in Microscopic Colitis

Long-term follow-up studies have shown that
in about 50% of the patients, the initially diagnosed LC
subsequently converted to CC. This has prompted some
authors to suggest that the morphology of the MC lies
along a continuous spectrum with a substantial overlap
between LC and CC.

They got their info from these two articles:
Mantzaris GJ, Archavlis E, Kourtessas D, et al. The natural history
of microscopic colitis and collagenous colitis after long-term
treatment with 5-aminosalicylic acid [abstract]. Gastroenterology.
1997;112:A1032.
Mashall JK, Irvine EJ. Lymphocytic and collagenous colitis:
medical management. Curr Treat Options Gastroenterol. 1999;2:
127–133.