Morphological and morphometric assessment of human duodenal biopsies maintained in organ culture. In vitro influences of gluten in coeliac disease.

Duodenal biopsy specimens from 51 coeliac patients (children and young adults) and 13 non-coeliac controls were maintained in organ culture for 24 h. Morphometric determinants were compared after culture in the presence of different gluten fractions, after culture on gluten-free medium, and in non-cultured specimens. Biopsies from patients with untreated coeliac disease were susceptible to gluten fractions, which provoked disorganization of crypt architecture, reduced height and irregularities of enterocytes and crypt cells, together with detrition of surface epithelial cells and even tissue necrosis. In latent coeliac disease (silent relapse) biopsies were more resistant to gluten, and higher concentrations were required to induce signs of morphological deterioration. Remission mucosa and biopsies from non-coeliac controls showed no signs of impairment after gluten exposure in vitro.