Georgian Scientists/ . 6 N 3, 2024 36 Georgian Scientists Vol. 6 Issue 3, 2024 https://doi.org/10.52340/gs.2024.06.03.05 1, 1, 1, 2, 2 1 ; 2 ; , . . , 2017-2024 . , . AgNOR- , , . , Qupath . : ; ; ; AgNOR; ; Marsh ; Georgian Scientists/ . 6 N 3, 2024 37 , [1]. , . , . , . , , [2]. HLA-DQ2 HLA-DQ8 , ( ) (tTG). , , , [3]. 99%- HLA-DQ2 HLA-DQ8 , 40%- . , , HLA-DQ2/DQ8- [4]. IgA (IgA class tissue antitransglutaminase antibodies (tTGA)) , IgA . tTG-IgA- IgA , . tTG , , , (2 ). tTG [ (ULN) 10- ], [5]. Georgian Scientists/ . 6 N 3, 2024 38 IgA (IgA class antiendomysial antibodies - EMA). IgA tTG- , [6]. [7]. , , , . , . 2-2 . [7]. 1 2 , , . , : 3a - , 3b - 3c - . Marsh , . -tTG- EmA- . , , , [8]. , , (Intraepithelial lymphocytosis - IELosis) , , [9]. , . 100 25- . CD3 CD8- T . , CD3 , T [8]. , , [10]. . . Georgian Scientists/ . 6 N 3, 2024 39 , 2017-2024 . , (FFPE) 180 . 30 - ; 30 - ; 30 - , Marsh 1; 30 - , Marsh 2; 30 - , Marsh 3a; 30 - , Marsh 3b. (H&E) , AgNOR- ) QuPath- . H&E AgNOR ( ; .). : Spearman rank test- Mann- Whitney Kruskal-Wallis . 95%- .P <0.05 . SPSS statistical software V29.0- . Georgian Scientists/ . 6 N 3, 2024 40 1: Qupath AgNOR- ; A. 400X AgNOR ; B. Qupath- ; ( (40.34 ± 1.4); , Marsh 2- (10.76 ± 1.2); Marsh 3b- (50.9 ± 3); (41.76 ± 1.1), , Marsh 2 (41.02 ± 1); . Marsh 3b (90.54 ± 2.1); Georgian Scientists/ . 6 N 3, 2024 41 Marsh 1 - (41.04 ± 1.8) Marsh 1- Marsh 3b (15.9 ± 0.9;) 2: H&E , ; A. , ; B. ; C. Marsh 2; D. Marsh 3b ; Georgian Scientists/ . 6 N 3, 2024 42 1: , ; . Marsh 1 (60.68) Marsh 3b- (15.9). Marsh 3b- (80.58), . (0.19); Marsh1- ; ) Marsh (P<0.05) . 5.4 ± 1 20.3 ± 1.7 41.76 ± 1.1 51.1 ± 1.4 39.3 ± 1.1 40.34 ± 1.4 20.04 ± 1.2 9.8 ± 1.2 59.94 ± 1.1 40.22 ± 1.4 , Marsh 1 10.5 ± 1.1 15.92 ± 1.2 31.82 ± 0.7 41.04 ± 1.8 60.68 ± 1.3 , Marsh 2 10.76 ± 1.2 20.46 ± 1.7 41.02 ± 1 60.22 ± 1.4 35.02 ± 1.5 , Marsh 3a 9.8 ± 1 30.24 ± 1.5 9.5 ± 1 80.5 ± 1.6 26.08 ± 1.4 , Marsh 3b 9.74 ± 1 50.9 ± 3 5.3 ± 1.1 90.54 ± 2.1 15.9 ± 0.9 Georgian Scientists/ . 6 N 3, 2024 43 2: ( ) 60.04 ± 1.4 20.5 ± 1.4 9.96 ± 1.8 2.926829268 6.02811245 39.3 ± 1.1 33 ± 1.8 19.4 ± 1.5 1.190909091 2.025773196 40.22 ± 1.4 34.34 ± 1.9 20.36 ± 1.5 1.171228888 1.975442043 , Marsh 1 60.68 ± 1.3 51.02 ± 1.5 33.94 ± 2 1.189337515 1.787860931 , Marsh 2 35.02 ± 1.5 61 ± 1.5 45.56 ± 1.7 0.5740983607 0.7686567164 , Marsh 3a 26.08 ± 1.4 70.6 ± 1.7 54.78 ± 1.2 0.3694050992 0.4760861628 , Marsh 3b 15.9 ± 0.9 80.58 ± 1.6 66.32 ± 1.2 0.1973194341 0.1973194341 Georgian Scientists/ . 6 N 3, 2024 44 AGNOR AGNOR AGNOR AGNOR 50.62 ± 1.7 20 2.531 60.04 ± 1.4 30 2.001333333 51.1 ± 1.4 25 2.044 39.3 ± 1.1 20 1.965 59.94 ± 1.1 40 1.4985 40.22 ± 1.4 21 1.915238095 , Marsh 1 41.04 ± 1.8 35 1.172571429 60.68 ± 1.3 14 4.334285714 , Marsh 2 60.22 ± 1.4 38 1.584736842 35.02 ± 1.5 7 5.002857143 , Marsh 3a 80.5 ± 1.6 44 1.829545455 26.08 ± 1.4 1 0.03 , Marsh 3b 90.54 ± 2.1 45 2.012 15.9 ± 0.9 0 0 AgNOR , . AgNOR- . AgNOR- AgNOR- , AgNOR- . AgNOR Marsh 3b- ; ; Georgian Scientists/ . 6 N 3, 2024 45 3: AgNOR- 400X; A.Marsh 3b; B.C. Marsh 3a; D Marsh 2; E. Marsh 1; F. ; Georgian Scientists/ . 6 N 3, 2024 46 1: ; 2: ( ) ; AgNOR- , , , , . , . Georgian Scientists/ . 6 N 3, 2024 47 Marsh 2 . , , . AgNOR- , . , , . , Qupath , , , . [1] G. Caio et al., “Celiac disease: a comprehensive current review.,” BMC Med, vol. 17, no. 1, p. 142, Jul. 2019, doi: 10.1186/s12916-019-1380-z. [2] U. Volta et al., “Minimal Lesions of the Small Intestinal Mucosa: More than Morphology.,” Dig Dis Sci, vol. 65, no. 10, pp. 2761–2768, Oct. 2020, doi: 10.1007/s10620-020-06571-1. [3] J. A. Tye-Din, H. J. Galipeau, and D. Agardh, “Celiac Disease: A Review of Current Concepts in Pathogenesis, Prevention, and Novel Therapies,” Front Pediatr, vol. 6, Nov. 2018, doi: 10.3389/fped.2018.00350. [4] S. Husby, J. A. Murray, and D. A. Katzka, “AGA Clinical Practice Update on Diagnosis and Monitoring of Celiac Disease-Changing Utility of Serology and Histologic Measures: Expert Review.,” Gastroenterology, vol. 156, no. 4, pp. 885–889, Mar. 2019, doi: 10.1053/j.gastro.2018.12.010. Georgian Scientists/ . 6 N 3, 2024 48 [5] K. Artykiewicz et al., “Celiac disease - a review on recent advances in characteristics, diagnostic and treatments,” Journal of Education, Health and Sport, vol. 13, no. 1, pp. 11–17, Nov. 2022, doi: 10.12775/JEHS.2023.13.01.001. [6] Y. Sahin, “Celiac disease in children: A review of the literature,” World J Clin Pediatr, vol. 10, no. 4, pp. 53–71, Jul. 2021, doi: 10.5409/wjcp.v10.i4.53. [7] V. Villanacci et al., “Celiac disease: histology-differential diagnosis-complications. A practical approach.,” Pathologica, vol. 112, no. 3, pp. 186–196, Sep. 2020, doi: 10.32074/1591-951X-157. [8] R. Del Sordo et al., “Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists.,” Diagnostics (Basel), vol. 12, no. 2, Feb. 2022, doi: 10.3390/diagnostics12020395. [9] R. Celli et al., “Clinical Insignficance of Monoclonal T-Cell Populations and Duodenal Intraepithelial T-Cell Phenotypes in Celiac and Nonceliac Patients,” American Journal of Surgical Pathology, vol. 43, no. 2, pp. 151–160, Feb. 2019, doi: 10.1097/PAS.0000000000001172. [10] A. Kirmizi et al., “Discriminant value of IEL counts and distribution pattern through the spectrum of gluten sensitivity: a simple diagnostic approach.,” Virchows Arch, vol. 473, no. 5, pp. 551–558, Nov. 2018, doi: 10.1007/s00428-018-2430-1. Dynamics of immunocompetent cell distribution in duodenitis and celiac disease Tamar Nikolaishvili1, Tsitsino Farulava1, Inga Mamuchishvili1, Nino Kantaria2, Giorgi Burkadze2 1Davit Agmashenebeli University of Georgia; 2Department of Pathological Anatomy of Tbilisi State Medical University; Abstract Celiac disease is an immune-mediated systemic disease caused by the ingestion of gluten and related prolamins in genetically sensitised individuals and characterised by various combinations of small intestinal lesions. Our study aimed to study the distribution of immunocompetent cells in celiac disease and other duodenitis. Within the framework of the study, a cohort retrograde study was carried out, for which archival material of the teaching-scientific and diagnostic laboratory of Tbilisi State Medical University for the years 2017-2024 was used. Based on the results of our study, the lymphoepithelial index may be used as a more accurate criterion of the degree of damage in celiac disease as well as a risk factor for progression, requiring more in-depth additional studies. AgNOR's additional staining method may assess the crypts' regeneration degree. Therefore, it can be used as an auxiliary criterion to evaluate the progression of celiac disease. In particular, assessing proliferative activity in the crypt epithelium, thus determining the degree of regeneration, maybe a more accurate marker of damage Georgian Scientists/ . 6 N 3, 2024 49 and progression. Digital assistants such as Qupath may be used to objectively assess the number of infiltrating lymphocytes and the degree of regeneration. Key words: celiac disease; duodenitis; immunocompetent cells; AgNOR; proliferative activity; Marsh Classification; : - PhD ; E-mail:tamar_nikolaishvili@yahoo.com Phone Number: 599 407 005 - ; ; E-mail: T.parulava@vian.health Phone Number: 577 721 149 - ; ; E-mail: Ingamamuchishvili@gmail.com Phone Number: 599 503 832 - ; Nino Kantaria– Resident in Clinical Pathology at Tbilisi State medical University E-mail: nqantaria4@gmail.com Phone Number: 568 458 845 - , ; George Burkadze - Professor at Tbilisi State Medical University, Head of the Department of Molecular Pathology; E-mail: burkadze@yahoo.com g.burkadze@tsmu.edu Phone Number: 599578833 https://orcid.org/0000-0002-5028-4537