Evaluation of colon mucosa using screening colonoscopy and flexible spectral imaging color enhancement in patients with long lasting ulcerative colitis

Abstract Background Ulcerative colitis (UC) has been associated with an increased risk of colorectal cancer (CRC). Although dye spray chromoendoscopy showed superiority to standard colonoscopy in surveillance studies, with the availability of higher-resolution colonoscopes, the utility of chromoendoscopy (CE) has been questioned. We aimed to evaluate the risk of intraepithelial neoplasia (IN) after a high-quality screening colonoscopy (making use of CE or random biopsies (RB) and removing all detected lesions) in a population with longstanding UC and to identify potential risk factors for dysplasia incidence. Methods In a previous study, 145 patients with clinically and endoscopic longstanding (≥8 yr) distal/extensive UC without primary sclerosing cholangitis and/or history of IN were prospectively randomised to undergo CE or RB. In this study, after a median follow-up of 5 additional years, we evaluated subsequent IN incidence in these patients, submitted to surveillance colonoscopy. Patients without high-quality surveillance colonoscopy (with good bowel preparation and cecum intubation) using high-definition were excluded. Results One hundred and twenty-one patients were included. Nine had removed adenomas with low-grade dysplasia in the index colonoscopy. Now, in surveillance colonoscopy, we detected 9 (7.4%) IN: low-grade dysplasia was found in 8 (6.6%) patients and a colorectal adenocarcinoma in 1 (0.008%) patient. After multivariate analysis, IN was significantly associated with older age (68 vs. 52 years, p < 0.05) and higher disease duration (26 vs. 20 years, p < 0.05). No association was found between IN and previous detection of IN in screening colonoscopy sex, the CE or RB use in index colonoscopy, extent of disease, The presence of pseudopolyps, smoking habits, familial history of CRC or maintenance therapy for UC. Conclusion In this study, older patients and higher disease duration were associated with a higher risk of IN in surveillance colonoscopy.

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Is histological remission of ulcerative colitis achievable?

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.08.200981 ◽

2021 ◽

Vol 93 (8) ◽

pp. 975-981

Author(s):

Oleg V. Knyazev ◽

Anna V. Kagramanova ◽

Sergei G. Khomeriki ◽

Asfold I. Parfenov

Keyword(s):

Ulcerative Colitis ◽

Clinical Remission ◽

Therapeutic Efficacy ◽

Disease Recurrence ◽

Mucosal Healing ◽

Colon Mucosa ◽

Normal Colon ◽

Laboratory Markers ◽

Important Challenge ◽

Histological Remission

Current conception of deep remission in patients with ulcerative colitis (UC) consists of clinical remission, endoscopic mucosal healing and normalization of laboratory markers. Histological remission should not be used as a primary end point for therapeutic efficacy, but instead should be considered as a marker of deep remission. The main goal of UC treatment should be focused on endoscopic healing of colon mucosa, decrease of inflammation activity, prolonged remission, absence of disease recurrence, and also histologic remission. Nevertheless, the term histologic remission has not yet been fully validated and no histologic indexes have been standardized. We need single unified definition for remission, based on multicentral studies analysis. One of important challenge is restoration of normal colon mucosal and results of multiple studies showed contradictory tests for assessing histologic remission, thus remaining an issue for further discussion.

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OC.14.3: PAD4 and Neutrophil Extracellular Traps are Increased in the Inflamed Colon Mucosa of Patients with Ulcerative Colitis

Digestive and Liver Disease ◽

10.1016/s1590-8658(17)30387-0 ◽

2017 ◽

Vol 49 ◽

pp. e117 ◽

Cited By ~ 1

Author(s):

V. Dinallo ◽

D. Di Fusco ◽

F. Laudisi ◽

A. Di Grazia ◽

E. Franzè ◽

...

Keyword(s):

Ulcerative Colitis ◽

Neutrophil Extracellular Traps ◽

Colon Mucosa ◽

Extracellular Traps

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Clinical validity of flexible spectral imaging color enhancement (FICE) in small-bowel capsule endoscopy: a systematic review and meta-analysis

Endoscopy ◽

10.1055/s-0042-122015 ◽

2017 ◽

Vol 49 (03) ◽

pp. 258-269 ◽

Cited By ~ 17

Author(s):

Diana Yung ◽

Pedro Boal Carvalho ◽

Andry Giannakou ◽

Uri Kopylov ◽

Bruno Rosa ◽

...

Keyword(s):

Systematic Review ◽

Small Bowel ◽

Capsule Endoscopy ◽

Meta Analysis ◽

Spectral Imaging ◽

Clinical Validity ◽

Color Enhancement

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P078 Efficiency of evaluating the expression of Toll-like receptors 2, 4, 6 and proteins proteomic profiling as integral indicators for predicting the risk of early relapse of ulcerative colitis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.207 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S174-S174

Author(s):

G Tarasova ◽

A Volkov ◽

A Iakovlev ◽

T Ghazudin ◽

I Shcherbakova

Keyword(s):

Ulcerative Colitis ◽

Molecular Markers ◽

Molecular Characteristics ◽

Colon Mucosa ◽

Proteomic Profiling ◽

Blood Monocytes ◽

Early Relapse ◽

Risk Of Recurrence ◽

Flight Mass Spectrometry ◽

Mass Spectrogram

Abstract Background Success was made in the study of TLR in congenital and adaptive immunity, which determined a new look at immune processes at ulcerative colitis (UC). Modern achievements of proteomic methods of analysis research allow to define molecular characteristics of the inflammation in colon mucosa of patients with UC. Methods The study included 86 patients with UC, an average age of 39.0 ± 1.4 years. Groups: 1–15 (17.4%) patients with distal form of UC, 2–42 (48%) left-sided form, 3–29 (33.7%) patients with total UC. The expression of TLR on peripheral blood monocytes was determined in the immunofluorescence test. Two-colour analysis was performed on a flow-through laser cytofluorimeter (Cytomics FC500, Beckman Coulte). The percentage of monocytes (CD14 + cells) carrying TLR2, TLR4, TLR6 on their surface was assessed. The separation of proteins of colon mucosa was based on technologies of IEF, SDS–PAGE, 2DPAGE (Bruker, USA). The getting of mass spectrogram was determined by matrix-assisted laser desorption-ionisation time-of-flight mass spectrometry (MALDI-TOF-MS/MS, Ultraflex II, Bruker, USA). Statistical analysis was performed using the software Statistica 10.0 (Statsoft). Results The direct average relationship was established between the number of monocytes expressing CD14 + CD282 +, CD14 + CD284 +, CD14 + CD286 + and the area of inflammation (r = 0.49, r = 0.55, r = 0.42, p < 0.05). The nonlinear regression equation was used. Calculation example: the risk of recurrence UC = exp (−26.1 + (0.4) × TLR 2)/(1 + exp (−26.1 + (0.4) × TLR 2)), χ2 = 130, 59, p < 0.0001. Thus, when the number of monocytes expressing TLR2 is not more than 60%, the risk of recurrence of the UC is not more than 11%, with values above 70%, the probability of recurrence exceeds 80%. We identified potentially new molecular markers of the early relapse of ulcerative colitis: SMAD2 activates the transcription of TFG1β and leads to development of fibrosis in colon submucosa in patients with UC; significant decrease of the expression of PPARγ promotes the activation of STAT and AP-1 signalling pathways that promotes the increase of the synthesis of IL-2,6,8,12,TNFα, the activity of immune and inflammation processes in colon mucosa; the reduction of expression of β-defensin-1 in cells of colon mucosa are accompanied with increased expression of CCR6, that promotes the formation of inflammatory infiltrates in colonic submucosa in UC. Conclusion Expression of TLR 2,4,6 in blood monocytes (the risk of recurrence UC ratio) and new protein molecular markers of colon mucosa (SMAD2, PPARγ and apoС-III) can be used as a tool for prediction of early relapse UC.

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