Duodenal biopsy is an important tool to diagnose coeliac disease (CD); however, the most reliable location of biopsy site
is still questionable. Claudins (CLDNs), members of a large family of adherent junction proteins, show characteristic expression
pattern in inflammatory disorders; nevertheless, CLDN expression in CD is unknown. This is a comparative study to examine
the CLDN 2, 3 and 4 expressions in proximal and distal part of duodenum in children with CD and in controls. Thirty-three
children with newly diagnosed CD were enrolled. Fourteen healthy children served as controls. Biopsies from proximal and distal
part of duodenum were taken for routine histological analysis. Immunohistochemistry were used to detect CD3+ intraepithelial
lymphocytes and CLDN 2, 3 and 4 protein expressions. Macroscopic picture, routine histology and Marsh grade depicted no differences
between biopsies taken from proximal or distal part of duodenum. However, CLDN 2 expression was significantly increased in
severe form of coeliac disease in bulb and in distal duodenum, and in distal part of non-severe coeliac patients, in comparison
to controls. Similar association was found concerning CLDN 3 expression. Expression of CLDN 4 was similar in all groups studied.
Both proximal and distal mucosal duodenal biopsies are suitable for diagnosing villous atrophy in patients with CD. Increased
expressions of CLDN 2 and 3 suggest structural changes of tight junction in coeliac disease which may be, at least in part,
responsible for increased permeability and proliferation observed in coeliac disease.
Keywords Claudin - Immunohistochemistry - Duodenum - Biopsy - Coeliac disease
Dorottya Nagy Szakál and Hajnalka Győrffy have equally contributed to this work.