{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:09:31Z","timestamp":1791464971593,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Considerable heterogeneity exists across studies assessing intestinal mucosal recovery in celiac (CD) patients on a gluten-free diet (GFD). We aimed at investigating histological and immunohistochemical features in CD patients on a long-term GFD and to correlate them to the GFD duration. Morphometrical and immunohistochemical analysis were retrospectively performed on duodenal biopsies in three groups of children: 33 on a long-term (&gt;2 years) GFD (GFD-group), four of which remained seropositive despite dietary adherence, 31 with villous atrophy (ACD-group) and 76 heathy, non-celiac (CTR-group). Moreover, in the GFD-group, we correlated immunohistochemical alterations to the GFD duration. The villous to crypt (V\/C) ratio significantly improved after the GFD and completely normalized in all patients, becoming even higher than in the CTR-group (median value 3.2 vs. 3, p = 0.007). In parallel, the number of CD3+ and TCR\u03b3\u03b4+ cells in the epithelium were significantly reduced in the GFD compared to ACD patients, even if they remained higher than in the CTR-group (p &lt; 0.05). In contrast, CD25+ cells in the lamina propria significantly decreased after the GFD (p &lt; 0.05) and become comparable to the CTR-group (p = 0.9). In the GFD-group there was no difference in the immunohistochemical parameters between seropositive and seronegative patients and alterations did not correlate to GFD length. In conclusion, a GFD is able to both restore a normal V\/C ratio and reduce inflammation, but the epithelium maintains some stigmata of the disorder, such as an increased number of CD3+ and TCR\u03b3\u03b4+ cells. These alterations persist regardless of the duration of the GFD.<\/jats:p>","DOI":"10.3390\/nu14183696","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T01:40:13Z","timestamp":1662601213000},"page":"3696","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Mucosal Healing in Celiac Disease: Villous Architecture and Immunohistochemical Features in Children on a Long-Term Gluten Free Diet"],"prefix":"10.3390","volume":"14","author":[{"given":"Roberta","family":"Mandile","sequence":"first","affiliation":[{"name":"Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariantonia","family":"Maglio","sequence":"additional","affiliation":[{"name":"European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Mosca","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Marano","sequence":"additional","affiliation":[{"name":"European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6158-0545","authenticated-orcid":false,"given":"Valentina","family":"Discepolo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, Italy"},{"name":"European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Troncone","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, Italy"},{"name":"European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Pediatrics Section University Federico II, via Pansini 5, 80131 Naples, Italy"},{"name":"European Laboratory for the Investigation of Food Induced Disease (ELFID), University Federico II, via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MPG.0000000000002497","article-title":"European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020","volume":"70","author":"Husby","year":"2020","journal-title":"J. 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