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Autistic enterocolitis: is it a histopathological entity?—reply
Author(s) -
Wakefield A J
Publication year - 2007
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2007.02607.x
Subject(s) - lesion , pathogenesis , enterocolitis , constipation , inflammation , pathology , disease , medicine , gastrointestinal disorder , immunology , gastroenterology
A series of studies in children with pervasive developmental disorder and gastrointestinal symptoms has reported the presence of a subtle mucosal inflammation, immunohistochemical abnormalities of structure and cellular infiltrate, pro‐inflammatory lymphocyte cytokine profiles, and functional intestinal abnormalities. MacDonald and Domizio question the existence of the mucosal lesion. In contrast, independent replication of the original findings has come from Europe, and North and South America; the data are presented. The willingness of the authors to attribute any mucosal changes to chronic constipation relies heavily on what appears to be a misinterpretation of data that is confounded by the association between cow's milk intolerance and constipation in children. A re‐challenge effect on intestinal symptoms and a biological gradient of mucosal inflammation is evident for an alternative environmental exposure in some children. Application of the research tools and methods that have been developed to examine the pathogenesis of inflammatory bowel disease should be applied to the investigation of affected children in order to further advance our understanding and treatment of this lesion.