The major indication for steroid treatment in AIP is the presence of symptoms. An initial prednisolone dose of 0.6 mg/kg/day, is recommend, which is then reduced to a maintenance dose over a period of 3-6 months. Maintenance treatment with low-dose steroid reduces but dose not eliminate relapses.

The Ikaros family of transcription factors (TFs) are important regulators of lymphocyte function. However, their roles in human innate lymphoid cell (ILC) function remain unclear. Here, we found that Ikaros (IKZF1) is expressed by all ILC subsets, including NK cells, in blood, tonsil, and gut, while Helios (IKZF2) is preferentially expressed by ILC3 in tonsil and gut. Aiolos (IKZF3) followed the expression pattern of T-bet and Eomes, being predominantly expressed by ILC1 and NK cells. Differentiation of IFN-γ-producing ILC1 and NK cells from ILC3 by IL-1β plus IL-12-stimulation was associated with upregulation of T-bet and Aiolos. Selective degradation of Aiolos and Ikaros by lenalidomide suppressed ILC1 and NK cell differentiation and expression of ILC1 and NK cell-related transcripts (LEF1, PRF1, GRZB, CD244, NCR3, and IRF8). In line with reduced ILC1/NK cell differentiation, we observed an increase in the expression of the ILC3-related TF Helios, as well as ILC3 transcripts (TNFSF13B, IL22, NRP1, and RORC) and in the frequency of IL-22 producing ILC3 in cultures with IL-1β and IL-23. These data suggest that suppression of Aiolos and Ikaros expression inhibits ILC1 and NK cell differentiation while ILC3 function is maintained. Hence, our results open up for new possibilities in targeting Ikaros family TFs for modulation of type 1/3 immunity in inflammation and cancer.Keywords: Aiolos r Ikaros r ILC r lenalidomide r NK cells Additional supporting information may be found online in the Supporting Information section at the end of the article.

BACKGROUND & AIMS: There is debate over the optimal method for colonoscopic surveillance of patients with inflammatory bowel diseases. Guidelines recommend chromoendoscopy, but the value of chromoendoscopy in high-definition colonoscopy has not been proven. Furthermore, the value of random biopsies is controversial. METHODS: We performed a prospective study of 305 patients with ulcerative colitis or Crohn's colitis referred for surveillance colonoscopy at a university hospital in Sweden, from March 2011 through April 2016. Patients randomly assigned to a group that received high-definition chromoendoscopy with indigo carmine (HD-CE; n [ 152), collection of 32 random biopsies, and targeted biopsies or polypectomies or to a group that received high-definition white light endoscopy (HD-WLE; n [ 153), collection of 32 random biopsies, and targeted biopsies or polypectomies. The primary endpoint was number of patients with dysplastic lesions. RESULTS: Dysplastic lesions were detected in 17 patients with HD-CE and 7 patients with HD-WLE (P [ .032). Dysplasias in random biopsies (n [ 9760) were detected in 9 patients: 6 (3.9%) in the HD-CE group and 3 (2.0%) in the HD-WLE group (P [ .72). Of the 9 patients with dysplasia, 3 patients (33%) had primary sclerosing cholangitis-only 18% of patients (54/305) included in the study had primary sclerosing cholangitis. The number of dysplastic lesions per 10 min of withdrawal time was 0.066 with HD-CE and 0.027 with HD-WLE (P [ .056). CONCLUSIONS: In a randomized trial, we found HD-CE with collection of random biopsies to be superior to HD-WLE with random biopsies for detection of dysplasia per colonoscopy. These results support the use of chromoendoscopy for surveillance of patients with inflammatory bowel diseases. ClinicalTrials.gov no: NCT01505842.

Based on the literature regarding the significance of intraepithelial lymphocytes (IELs) in the initiation of EoE, we submit that the IEL phenotypes in LyE might differ from those found in EoE as they were unable to elicit the same eosinophilic response. Recent studies disclosed that group 2 innate lymphocytes (ILC2s), enriched in EoE, remain undetected in CD3 immunostain as they lack surface markers for T, B, natural killer (NK) or NK T cells. If ILC2s also participate in the lymphocytic infiltration of EoE, then the frequency of cases with Co LyE-EoE here reported might have been much higher. The four oesophagitis phenotypes described are easy to recognise, provided that the dual staining procedure (H&E-CD3) is implemented.

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No specific endoscopic signs for diagnosing eosinophilic esophagitis (EoE) have been described and very few studies have reported endoscopic signs for lymphocytic esophagitis (LyE). This study aimed to assess the utility of narrow-band imaging magnifying endoscopy (NBI-ME) in predicting EoE/LyE diagnosis before histopathological assessment. Adult patients with dysphagia and/or food impaction who underwent esophagogastroduodenoscopy followed by NBI-ME and biopsies were included. Three previously reported NBI-ME signs were studied: beige mucosa, dot-shaped intra-epithelial papillary capillary loop (IPCL), and absent cyan vessels. These signs were compared with the histological diagnosis, and studied in patients with and without EoE or LyE. A predictive model containing the NBI-ME signs was analyzed, based on area under the curve (AUC). A total of 137 patients were enrolled. Based on histology 26 were diagnosed with EoE, 26 with LyE, and 85 were control patients with neither diagnosis. Significantly more EoE/LyE patients than control patients showed the NBI signs ( < 0.001 for all three signs). Absent cyan vessels had the highest accuracy for differentiation (sensitivity 88 %, specificity 92 %). A combination of age, dot IPCLs, and absent cyan vessels was highly predictive of EoE/LyE, with an AUC of 0.952. Three NBI-ME signs were found in the majority of patients with EoE/LyE and unlikely to be observed in controls. A combination of two NBI-ME signs and younger age had a higher degree of accuracy. This supports the claim that NBI-ME could be a reliable diagnostic modality for EoE/LyE predictors.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of salivary stimulation and esophageal secretion of protective factors in prevention of adenocarcinoma sequelae in gastroesophageal reflux disease; the pediatric conditions associated with esophageal cancer; the relationship of achalasia and pseudoachalasia with esophageal cancer; the potential for malignant transformation in eosinophilic esophagitis and overlap syndromes; the role of lymphocytic esophagitis as an overlapping phenotype; the role of Barrett's esophagus as a premalignant condition; the indications and type of treatment of premalignant conditions of the esophagus; and the decision for use of endoscopical procedures in premalignant conditions of the esophagus.

20mm vs. 31mm) in UC group. There were no significant differences about treatment outcome such as R0 resection rate (100% vs.95.4%), curative resection rate (89.5% vs. 90.3%), perforation rate (10.5% vs.7.7%), postoperative bleeding (5.3% vs. 2.2%) and procedure time (67min. vs. 58 min.). Additionally, we evaluated the risk factor of prolonged procedure time over 60min, which indicates technical difficulty in UC patients. Among the clinicopathological characteristics (sex, age, location, macroscopic type, tumor size, extent of disease and duration of disease), tumor size and duration of disease were risk factors affecting to the technical difficulty. Conclusion: Colorectal ESD in patients with UC was feasible, because there were no significant differences according to the rate of adverse events and resectability even when compared with common superficial neoplasms. However, we should treat carefully for patients with larger lesions and long duration of disease due to prolonged procedure time.