Year 2025 / Volume 117 / Number 12
Editorial
Decoding the immunophenotype ‒ New perspectives in understanding celiac disease

712-715

DOI: 10.17235/reed.2025.11160/2025

Carlota García-Hoz, Roberto Pariente, Garbiñe Roy Ariño,

Abstract
An increase in duodenal intraepithelial lymphocytes (IELs) is a characteristic finding in coeliac enteropathy. Flow cytometry analysis of this compartment, known as the ‘duodenal IEL lymphogram’, is a quick and simple technique that allows us to identify with high diagnostic accuracy the phenotype and distribution of the IEL subpopulations that characterise, in an almost pathognomonic way, the underlying celiac process. We contribute our experience as a pioneering group in the clinical implementation of this technique, adding certain reflections with the aim of harmonising minor discrepancies between laboratories when interpreting the parameters analysed.
New comment
Comments
No comments for this article
References
1. Singh P, Arora A, Strand TA, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2018;16(6):823-836. doi: 10.1016/j.cgh.2017.06.037.
2. Abadie V, Han AS, Jabri B, et al. New Insights on Genes, Gluten, and Immunopathogenesis of Celiac Disease. Gastroenterology. 2024 Jun;167(1):4-22. doi: 10.1053/j.gastro.2024.03.042
3. Lebwohl B, Sanders DS, Green PHR. Celiac Disease. Lancet. 2018 Jan 6;391(10115):70-81. doi: 10.1016/S0140-6736(17)31796-8.
4. Volta U, Caio G, Boschetti E, et al. Seronegative celiac disease: Shedding light on an obscure clinical entity. Digestive and liver disease: official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 2016;48(9):1018-22. doi: 10.1016/j.dld.2016.05.024
5. Jansson-Knodell CL, Hujoel IA, Rubio-Tapia A, et al. Not All That Flattens Villi Is Celiac Disease: A Review of Enteropathies. Mayo Clinic proceedings. 2018;93(4):509-17. doi: 10.1016/j.mayocp.2017.10.025.
6. Mayassi T, Jabri B. Human intraepithelial lymphocytes. Mucosal Immunol. 2018 Sep;11(5):1281-1289. doi: 10.1038/s41385-018-0016-5.
7. Kornberg A, Botella T, Moon CS, et al. Gluten induces rapid reprogramming of natural memory αβ and γδ intraepithelial T cells to induce cytotoxicity in celiac disease.Sci Immunol. 2023 Jul 21;8(85):eadf4312. doi: 10.1126/sciimmunol.adf4312.
8. Levescot A, Malamut G, Cerf-Bensussan N. Immunopathogenesis and environmental triggers in coeliac disease. Gut. 2022 Jul 25;71(11):2337-49. doi: 10.1136/gutjnl-2021-326257.
9. Camarero C, De Andrés A, García-Hoz C, et al. Assessment of Duodenal Intraepithelial Lymphocyte Composition (Lymphogram) for Accurate and Prompt Diagnosis of Celiac Disease in Pediatric Patients. Clin Transl Gastroenterol. 2021 Nov 10;12(11):e00426. doi: 10.14309/ctg.0000000000000426.
10. García-Hoz C, Crespo L, Pariente R, et al. Intraepithelial Lymphogram in the Diagnosis of Celiac Disease in Adult Patients: A Validation Cohort. Nutrients. 2024 Apr 10;16(8):1117. doi: 10.3390/nu16081117.
11. Grupo de trabajo del Protocolo para el diagnóstico precoz de la enfermedad celiaca. In: Ministerio de Sanidad, Servicios Sociales e Igualdad. Canary Islands, Spain: Servicio de Evaluación del Servicio Canario de la Salud (SESCS) (2018).
12. Fernandez-Banares F, Carrasco A, Martin A, Esteve M. Systematic Review and Meta-Analysis: Accuracy of Both Gamma Delta+ Intraepithelial Lymphocytes and Coeliac Lymphogram Evaluated by Flow Cytometry for Coeliac Disease Diagnosis. Nutrients. 2019;11(9). doi: 10.3390/nu11091992
13. Basu K, Creasey H, Bruggemann N, Stevens J, Bloxham D, Woodward JM. Diagnosis of coeliac disease by flow cytometry of intraepithelial lymphocytes: a new 'gold' standard? Frontline gastroenterology. 2022;13(2):119-25. doi: 10.1136/flgastro-2021-101838
14. Fernandez-Banares F, Crespo L, Nunez C, Lopez-Palacios N, Tristan E, Vivas S, et al. Gamma delta(+) intraepithelial lymphocytes and coeliac lymphogram in a diagnostic approach to coeliac disease in patients with seronegative villous atrophy. Alimentary pharmacology & therapeutics. 2020;51(7):699-705. doi: 10.3390/nu16020232
15. Ruiz-Ramirez P, Carreras G, Fajardo I, Tristan E, Carrasco A, Salvador I, et al. Intraepithelial Lymphocyte Cytometric Pattern Is a Useful Diagnostic Tool for Coeliac Disease Diagnosis Irrespective of Degree of Mucosal Damage and Age-A Validation Cohort. Nutrients. 2021;13(5). doi: 10.3390/nu13051684
16. Fernandez-Banares F, Nunez C, Montoro M, Roy G, Esteve M. Management of Small Bowel Villous Atrophy in Patients Seronegative for Celiac Disease: High Diagnostic Accuracy of Celiac Lymphogram. The American journal of gastroenterology. 2020;115(12):2110. doi: 10.14309/ajg.0000000000000768
17. Nijeboer P, van Gils T, Reijm M, Ooijevaar R, Lissenberg-Witte BI, Bontkes HJ, et al. Gamma-Delta T Lymphocytes in the Diagnostic Approach of Coeliac Disease. Journal of clinical gastroenterology. 2019;53(5):e208-e13. doi: 10.1097/MCG.0000000000001060
18. Saborido R, Martinon N, Regueiro A, Crujeiras V, Eiras P, Leis R. Intraepithelial lymphocyte immunophenotype: a useful tool in the diagnosis of celiac disease. Journal of physiology and biochemistry. 2018;74(1):153-8. doi: 10.1007/s13105-017-0586-9
19. Martín-Cardona A, Carrasco A, Arau B, et al. γδ+ T-Cells Is a Useful Biomarker for the Differential Diagnosis between Celiac Disease and Non-Celiac Gluten Sensitivity in Patients under Gluten Free Diet. Nutrients. 2024 Jul 17;16(14):2294. doi: 10.3390/nu16142294
20. Mayassi T, Ladell K, Gudjonson H, et al. Chronic Inflammation Permanently Reshapes Tissue-Resident Immunity in Celiac Disease. Cell. 2019 Feb 21;176(5):967-981.e19. doi: 10.1016/j.cell.2018.12.039.
21. Risnes LF, Eggesbø LM, Zühlke S, et al. Circulating CD103+ γδ and CD8+ T cells are clonally shared with tissue-resident intraepithelial lymphocytes in celiac disease. Mucosal Immunol. 2021 Jul;14(4):842-851. doi: 10.1038/s41385-021-00385-8.
22. Fernández-Bañares F, López-Palacios N, Corzo M et al. Activated gut-homing CD8+ T cells for coeliac disease diagnosis on a gluten-free diet. BMC Med. 2021 Oct 6;19(1):237. doi: 10.1186/s12916-021-02116-z.
23. Roy G, Fernández-Bañares F, Corzo M, et al. Intestinal and blood lymphograms as new diagnostic tests for celiac disease.Front Immunol. 2023 Jan 10;13:1081955. doi: 10.3389/fimmu.2022.1081955.
Related articles

Letter

Liver disorders and celiac disease

DOI: 10.17235/reed.2023.9516/2023

Digestive Diseases Image

Calcified cavitating mesenteric lymph node syndrome: a rare complication of celiac disease

DOI: 10.17235/reed.2020.7494/2020

Letter

Balanced by iron. Hereditary hemochromatosis and celiac disease

DOI: 10.17235/reed.2020.7269/2020

Review

New celiac disease biomarkers

DOI: 10.17235/reed.2020.7217/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Original

Coping with celiac disease: how heavy is the burden for caregivers?

DOI: 10.17235/reed.2017.4518/2016

Letter to the Editor

Celiac disease and fibromyalgia: Is there an association?

DOI: 10.17235/reed.2015.3992/2015

Citation tools
García-Hoz C, Pariente R, Roy Ariño G. Decoding the immunophenotype ‒ New perspectives in understanding celiac disease. 11160/2025


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 15 visits.
This article has been downloaded 1 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 18/02/2025

Accepted: 20/02/2025

Online First: 17/11/2025

Published: 12/12/2025

Article Online First time: 272 days

Article editing time: 297 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2025 y Creative Commons. The Spanish Journal of Gastroenterology