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Table 2 Effect of moderate (3-5g) and low (1-3g) amounts of gluten on small-bowel mucosal villous height crypt depth ratio (Vh/CrD), densities of CD3+ intraepithelial lymphocytes (IELs) and gastrointestinal symptoms in treated celiac disease patients.

From: Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease

No Mean daily gluten intake (g) Duration of gluten challenge (days) Small-bowel biopsy Symptoms‡
    Vh/CrD* CD3+ IELs†   
    I II I II I II
Moderate amounts of gluten daily     
1 5.0 29 2.8 0.8 33 88 0 ++
2 4.9 84 3.5 3.4 43 84 0 0
3 4.9 38 2.9 1.3 64 128 0 ++
4 4.7 45 2.7 0.2 70 113 0 +
5 4.1 61 3.0 3.5 41 56 0 ++
6 4.0 91 3.0 0.6 45 97 0 +
7 3.6 91 2.8 1.4 42 125 0 0
8 3.6 84 3.0 2.6 38 47 0 +
9 3.4 88 3.8 2.3 69 83 0 +
10 3.3 86 2.7 0.6 68 96 0 +
Low amounts of gluten daily     
11 2.8 89 2.5 3.1 87 52 0 +
12 2.7 84 3.0 0.6 87 117 0 0
13 2.6 81 2.9 3.1 49 50 0 0
14 2.4 85 2.7 1.9 146 271 0 +
15 2.2 103 4.2 1.3 23 48 0 +
16 2.1 93 1.3 0.1 130 99 0 +
17 2.1 85 3.3 2.4 100 79 0 +
18 2.1 84 2.9 1.7 75 78 0 0
19 2.1 83 3.2 3.4 70 123 0 +
20 1.4 77 3.4 3.0 41 87 0 ++
21 1.3 78 2.5 0.8 53 71 0 0
Altogether positive outcome§, n (%) 14 (67%) 14 (67%) 15 (71%)
  1. Clinically significant changes between baseline (I) and 12 weeks' follow-up examination (II) are marked in bold numbers. Complete challenge lasted 12 weeks (84 ± 14 days).
  2. * Abnormal ratio compatible with active celiac disease <2.0
  3. † Reference value for CD3+ IELs 37 cell/mm
  4. ‡ Symptoms graded as 0 = no symptoms, + = mild symptoms, ++ = moderate symptoms,
  5. § Positive outcome reported when clinically significant changes appeared (>0.5 decrease in Vh/CrD, >30% increase in IEL densities) or when symptoms worsened.