THE MARSH CLASSIFICATION- MATTERS ARISING -

PROF. MICHAEL N. MARSH,WOLFSON COLLEGE,UNIVERSITY OF OXFORD

2

GLUTEN, MAJOR HISTOCOMPATIBILITY COMPLEX, & THE SMALL INTESTINE:

A MOLECULAR & IMMUNOBIOLOGIC APPROACH TO GLUTEN-SENSITIVITY

MARSH, M.N.GASTROENTEROLOGY 102: 330-354, 1992

TYPE 0

PRE-INFILTRATIVE

INFILTRATIVE

TYPE 1

INFILTRATIVE -HYPERPLASTIC

TYPE 2

DESTRUCTIVEFLAT -

TYPE 3

ATROPHIC -HYPOPLASTIC

TYPE 4

SURFACEEPITHELIAL

4

CORAZZA G, VILLANACCI V:J CLIN PATH 58: 573, 2005

(TYPE 0)

PRE-INFILTRATIVE

INFILTRATIVE

(TYPE 1)

INFILTRATIVE --HYPERPLASTIC

(TYPE 2)

DESTRUCTIVEFLAT -

(TYPE 3)

SURFACEEPITHELIAL

6

(TYPE 0)

PRE-INFILTRATIVE

INFILTRATIVE

(TYPE 1)

INFILTRATIVE --HYPERPLASTIC

(TYPE 2)

DESTRUCTIVEFLAT -

(TYPE 3)

SURFACEEPITHELIAL

8

CORAZZA G, VILLANACCI V: J CLIN PATH 58: 573, 2005

OBERHUBER G et al.,EUR J GASTRO/HEP 11: 1185, 1999

9

10

11

12

13

14

15

16

17

CORAZZA G, VILLANACCI V:J CLIN PATH 58: 573, 2005

OBERHUBER G et al.,EUR J GASTRO/HEP 11: 1185, 1999

BROWN I et al.,ARCH PATHOL LAB MED 130: 1020, 2006

WALKER M et al.,GASTROENTEROLOGY 139: 112. 2010

DICKSON BC et al.,J CLIN PATHOL 59: 1008, 2006

(TYPE 0)

PRE-INFILTRATIVE

INFILTRATIVE

(TYPE 1)

INFILTRATIVE -HYPERPLASTIC

(TYPE 2)

DESTRUCTIVEFLAT -

(TYPE 3)

SURFACEEPITHELIAL

0.62.6 1.7

2.3

Muscularis Mucosae 104 µm2

Controls Untreated CD Treated CD

Surfaceepithelium

Cryptepithelium

Laminapropria 1.4

2.8

1.01.90.6

( Test Area )

20

CELL VOLUME

r r'

r"

(a) - Cylinder (b) - Truncated Conoid

V = r2 h V = [r"2+(r"r')+r'2]h3

hh

22

23

24

25

26

(TYPE 0)

PRE-INFILTRATIVE

INFILTRATIVE

(TYPE 1)

INFILTRATIVE -HYPERPLASTIC

(TYPE 2)

DESTRUCTIVEFLAT -

(TYPE 3)

SURFACEEPITHELIAL

28

SURFACEEPITHELIAL