Staining for cell surface markers was carried out on ice for 20 min. The percentage of CD4+ T cells that had proliferated was determined by gating the CD4+CFSElow subset. The cell division index for different antigens (CDI) was calculated as follows: percentage of CD4+CFSElow cells in stimulated culture/percentage of CD4+CFSElow cells in unstimulated culture. Statistical analyses were Wnt inhibitor conducted using GraphPad Prism version 5·0 (GraphPad Software, San Diego, CA, USA). Fisher’s exact test and the two-tailed Mann–Whitney U-test was used as indicated. Spearman’s rank correlation test was used to calculate the correlation between increase percentages

in TT stimulation and subjects’ age. P-values less than 0·05 were considered selleck compound significant. To investigate whether gliadin-specific CD4+ T cells are detectable in the peripheral blood of children with newly diagnosed CD we compared the T

cell responses of 20 CD children to those of 64 healthy controls carrying the CD-associated HLA-DQ alleles, DQ2 or DQ8. Freshly isolated PBMCs were stimulated with native gliadin and gTG as well as two synthetic gliadin peptides (Q12Y and P14Y) reported to contain major gliadin epitopes [5]. TTG, TT and PHA were used as control antigens. The CD4+ T cell proliferative response to the antigens was analysed by flow cytometry after 10 days’ incubation using the CFSE dilution assay [13]. Individual responses to an antigen were considered positive when the cell division index (CDI) was ≥2·0 and the difference in the percentage of CD4+CFSElow cells between stimulated and unstimulated cultures was at least 0·5%. With these criteria, 11 of 20 children

with CD (55%) had a positive response to gTG compared to 15 of 64 control children (23·4%) (P = 0·008; Fisher’s exact test) (Table 1). The average intensity of the proliferative responses to gTG was also significantly stronger in children with CD than in controls (Fig. 1) (P = 0·01; Mann–Whitney U-test). In contrast to gTG, T Acetophenone cells specific to native gliadin were detectable at comparable frequencies in children with CD (two of 19, 10·5%) and control children (13 of 64, 20·3%) (Table 1). Moreover, the intensity of proliferative responses to native gliadin did not differ between children with CD and healthy controls (Fig. 1). Importantly, when the proliferative responses to native gliadin and gTG were compared directly, children with CD clearly had stronger proliferative responses to gTG, whereas in the control group the responses to gTG did not differ from those against the native gliadin (Fig. 2). Taken together, these findings suggest that the deamidation of gliadin enhances peripheral blood CD4+ T cell responses in children with CD but not in healthy controls.