ReviewGastroenterology and hepatology from bed to bench2015
Mucosal histopathology in celiac disease: a rebuttal of Oberhuber's sub-division of Marsh III.
Review in Gastroenterology and hepatology from bed to bench, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- European Society for the Study of Coeliac Disease 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 1: Diagnostic Approach.United European gastroenterology journal · 2025Guideline
- Prevalence of celiac disease in low and high risk population in Asia-Pacific region: a systematic review and meta-analysis.Scientific reports · 2021Pooled it
- Gluten sensitivity and epilepsy: a systematic review.Journal of neurology · 2019Pooled it
- Diagnostic clues in patients with clinical malabsorption and pathological small intestinal villous atrophy: Immune-mediated type and beyond.World journal of gastroenterology · 2026Review
- The hidden link between iron deficiency and celiac disease: a clinical perspective.Frontiers in immunology · 2026Article
- Recent Trend of Laboratory Tests in Common Gastrointestinal Tract Disorders.Diagnostics (Basel, Switzerland) · 2025Review
- Viral infections in celiac disease: what should be considered for better management.Clinical and experimental medicine · 2024Review
- Celiac disease diagnosis: transglutaminase, duodenal biopsy and genetic tests correlations.Frontiers in pediatrics · 2024Article
- Marsh's legacy and persistency in subjective interpretation of coeliac disease's histology.Gastroenterology and hepatology from bed to bench · 2023Article
- No-biopsy diagnostic approach to coeliac disease.Gastroenterology and hepatology from bed to bench · 2023Review
- The differential diagnoses for severe enteropathy or severely damaged small intestinal mucosa.Gastroenterology and hepatology from bed to bench · 2023Article
- Article
- Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study.Nutrients · 2022Article
- Is duodenal biopsy always necessary for the diagnosis of coeliac disease in adult patients with high anti-tissue transglutaminase (TTG) antibody titres?Frontline gastroenterology · 2022Article
- The Activity of Antimicrobial Peptides in Pediatric Celiac Disease.Frontiers in pediatrics · 2022Article
- Frequency and Clinical Aspects of Neurological and Psychiatric Symptoms in Patients with Non-Celiac Wheat Sensitivity.Nutrients · 2021Article
- Different Clinical Features of Celiac Disease in Children, Adolescents, and Adults; a Cross-sectional Study.Middle East journal of digestive diseases · 2021Article
- Screening of Altered Metabolites and Metabolic Pathways in Celiac Disease Using NMR Spectroscopy.BioMed research international · 2021Article
- Apolipoprotein A4 Defines the Villus-Crypt Border in Duodenal Specimens for Celiac Disease Morphometry.Frontiers in immunology · 2021Article
- An updated overview of spectrum of gluten-related disorders: clinical and diagnostic aspects.BMC gastroenterology · 2020Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Individuals with particular genetic backgrounds develop immune responses to wheat proteins and become 'gluten-sensitised'. Mucosal pathology arises through activated mucosal T lymphocytes, resulting in a graded, adverse reaction between particular genes and wheat proteins. Given these varied influences, the Marsh Classification broadly itemises those stages through which a normal mucosa (Marsh 0) evolves in becoming 'flat' (Marsh I, II, III). Recently, Oberhuber and colleagues suggested that Marsh III lesions required subdividing into a, b, c categories. We critically examined these subdivisions by means of correlative light and scanning electron microscopy (SEM). Our results demonstrate that Oberhuber's classification is untenable. In our view deriving from our observations, the artificial subdivisions proposed by those authors actually reflect misinterpretations of the true architectural contours of flat mucosae. Although these workers refer to "villous projections", SEM demonstrates that no such structures are present on flat - or immediately recovering - mucosae. Our data revealed on the surfaces of flat (Marsh III) mucosae, large open "basins", surrounded by raised collars - the latter, when viewed in histological section, being easily misconstrued as "villi". It seems that with subsequent upward growth, these collars coalesce into low ridges, thence becoming broader and higher convolutions. It is noticeable that there are more open spaces on the surfaces of flat mucosae than was appreciated hitherto. We conclude that Oberhuber's revisions of Marsh III into three subcategories (a, b, c), are misinterpretations of the histological appearances of flattened mucosae. Therefore, histopathologists when classifying celiac mucosae, since they add nothing either of diagnostic, nor prognostic, value should resist these subcategories.
Indexed as
Identifiers
25926934PMC4403022W1557055498What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.