Review for 10.1186/s12876-019-1089-7 (2019)

Reviewer ’s report  
 
Title: Histological, immunohistochemical and mRNA gene expression responses in coeliac  
disease patients challenged with gluten using PAXgene fixed paraffin -embedded duodenal  
biopsies  
 
Version: 0 Date: 13 Aug 2019  
 
Reviewer: Rong Jun Guo  
 
Reviewer's report:  
 
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This is an interesting technical study attempting a quantitative approach to  evaluating 
histological changes in the small intestine in the pathogenesis of celiac disease.   I have two 
concerns regarding this study:  
 
1) As we all know RNAs extracted from formalin -fixed tissues, in many cases, work pretty well.  
The authors argue th at, in some RNAs, formalin fixation do not work.  That was why the authors 
thought PAX gene was a better choice.  However, the authors did not perform a parallel study 
comparing these two fixatives when they performed their RNA study, raising the suspicion  that 
formalin fixed tissues might also work for the expression of the two genes they studied.  
 
2) In all of cases the authors studied, I assume the diagnosis had been established before the 
patients were registered.  The diagnosis of a celiac disease is b ased on clinical, serological and 
histological correlation.  The typical histological features are characteristic of , but not specific 
for, a celiac disease.  Several other entities can result in identical histological changes, such as 
Crohn disease, and medication -related injury.   The authors should clearly address this limitation.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional s tatistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Accept able 
 
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