A MORPHOLOGICAL AND HISTOCHEMICAL 



ANALYSIS OF THE HUMAN JEJUNAL 



EPITHELIUM IN NON-TROPICAL SPRUE 



HELEN A. PADYKULA. ELLIOTT W. STRAUSS, A. J. LADMAN, 



and F H. GARDNER 



Departments of Anatomy and Medicine, Harvard Médical School, Boston, 



Massachusetts, U.S.A 



latraluminal biopsy methods hâve correlated clinical findings in non- 

 tropical sprue with a mucosa composed of short blunt villi and long 

 dilated crypts (Shiner, 1956). Histochemical and électron microscopic 

 studies were made on mucosal biopsies from 13 patients with sprue, 

 2 healthy physicians, and 26 hospitalized controls. 



In normal epithelium, undifferentiated cells of the crypts (zone 1) 

 acquire greater phosphatase, esterase, and succinic dehydrogenase activ- 

 ity as they differentiate into absorptive cells of the villi (zone 2). Cyto- 

 plasmic basophilia (ribonucleoprotein) diminishes progressively as the 

 cells migrate toward the apex of the villas. 



In sprue three zones cem be recognized in jejunal epithelium by histo- 

 chemical methods. The apparent crypt has a basai région composed princi- 

 pally of undifferentiated cells (zone 1) and an upper région of normal 

 appearing absorptive cells (zone 2). Thus, the upper crypt in sprue cor- 

 responds histochemically to part of the villus in the normal. The surface 

 epithelium (zone 3) is rich in cytoplasmic ribonucleoprotein but déficient 

 in esterase, succinic dehydrogenase, and phosphatases. Absorptive cells 

 frequently show ultrastructural abnormalities in mitochondria and micro- 

 villi. In sprue mitotic activity of the epithelium is elevated, mitoses occur 

 on the villi, and crypts (zone 1) are lengthened two fold. Thèse findings 

 suggest disturbances in differentiation and rate of replacement of the epi- 

 thelium. 



Expérimental comparison of triglycéride uptake in vivo by normal and 

 abnormal villi demonstrates a lower rate of epithelial absorption in sprue. 



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