Imaging active lymphocytic infiltration in coeliac disease with iodine- 123-interleukin-2 and the response to diet

Alberto Signore, Marco Chianelli, Alessio Annovazzi, Maurizio Rossi, Luigi Maiuri, Marco Greco, Giuseppe Ronga, Keith E. Britton, Antonio Picarelli

Research output: Contribution to journalArticlepeer-review


Coeliac disease is diagnosed by the presence of specific antibodies and a jejunal biopsy showing mucosal atrophy and mononuclear cell infiltration. Mucosal cell-mediated immune response is considered the central event in the pathogenesis of coeliac disease, and untreated coeliac patients show specific features of T-cell activation in the small intestine. Here we describe the use of iodine-123-interleukin-2 scintigraphy in coeliac patients as a non- invasive tool for detection of lymphocytic infiltration in the small bowel and its use for therapy follow-up, and we demonstrate the specificity of binding of labelled-IL2 to activated lymphocytes by ex-vivo autoradiography of jejunal biopsies. 123I-IL2 was administered i.v. [74 MBq (2 mCi)], and gamma camera images were acquired after 1 h. Ten patients were studied with 123I-IL2 scintigraphy at diagnosis and seven were also investigated after 12-19 months of gluten-free diet. Results were expressed as target-to- background radioactivity ratios in six different bowel regions before and after the diet. At the time of diagnosis all patients showed a significantly higher bowel uptake of 123I-IL2 than normal subjects (P2=0.66; P=0.008). Autoradiography of jejunal biopsies confirmed that labelled-IL2 only binds to activated T-lymphocytes infiltrating the gut mucosa. After 1 year of the diet, bowel uptake of 123I-IL2 significantly decreased in five out of six regions (P123I-IL2 scintigraphy is a sensitive non- invasive technique for assessing in vivo the presence of activated mononuclear cells in the bowel of patients affected by coeliac disease. Unlike jejunal biopsy, this method provides information from the whole intestine and gives a non-invasive measure of the effectiveness of the gluten-free diet.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalEuropean Journal Of Nuclear Medicine
Issue number1
Publication statusPublished - 2000


  • Activated T cells
  • Coeliac disease
  • Interleukin-2
  • Scintigraphy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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