A reproducible grading scale for histological assessment of inflammation in ulcerative colitis

Geboes, Karel; Riddell, Robert H.; Öst, Åke; Jensfelt, B; Persson, Tore; Löfberg, Robert

doi:10.1136/gut.47.3.404

Cited by 815 publications

(691 citation statements)

References 24 publications

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“…No patients with post-infectious colitis were included. Group 2 included 20 patients (10 men and 10 women, age range: 21-50, mean: 39.5 years) with active UC with an average duration of 5.9 years (range: 0.5-25 years) and activity estimated using the histological scoring system according to Geboes et al (Geboes et al 2000) amounting to 4.3 in 14 patients and 5.3 in the remaining 6 patients. Group 3 included 12 patients (6 men and 6 women, age range: 15-42, mean: 28.6 years) with active CD with an average duration of 4.2 years (range: 0.5-34 years) and an average clinical activity CDAI score of over 150 points (Best et al 1976).…”

Section: Patientsmentioning

confidence: 99%

Proinflammatory cytokines and IL-10 in inflammatory bowel disease and colorectal cancer patients

Szkaradkiewicz

Marciniak

Chudzicka-Strugała

et al. 2009

Arch. Immunol. Ther. Exp.

110

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Introduction: The aim of the study was to describe the levels of circulating monocyte/macrophage pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-8) and an anti-inflammatory cytokine (IL-10) in inflammatory bowel disease (IBD) and colorectal cancer (CRC) patients and healthy controls. Materials and Methods:The study was conducted on 15 healthy individuals, 20 patients with ulcerative colitis (UC), 12 with Crohn's disease (CD), and 15 with CRC (Dukes' stage B). Blood serum cytokine levels were measured by ELISA. Results: The patients with UC had significantly higher levels of the pro-inflammatory cytokines and of circulating IL-10 than the healthy controls. The patients with CD and CRC had the same specific pattern of serum cytokines of significantly elevated levels of the pro-inflammatory cytokines, but the IL-10 levels were within the range found in the healthy individuals. Conclusions: Thus our results demonstrate that both IBD and CRC are linked with an intensified production of a wide array of monocyte/macrophage pro-inflammatory cytokines which is not accompanied by elevated levels of circulating IL-10, except for its insufficiently inhibitory elevation in UC patients.

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Section: Patientsmentioning

confidence: 99%

Proinflammatory cytokines and IL-10 in inflammatory bowel disease and colorectal cancer patients

Szkaradkiewicz

Marciniak

Chudzicka-Strugała

et al. 2009

Arch. Immunol. Ther. Exp.

110

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“…Colitis severity scores were assessed in a blinded fashion by a single pathologist (E.S.S.) according to a previously described scoring system (38).…”

Section: Dss Colitis Studiesmentioning

confidence: 99%

Control of inflammation by stromal Hedgehog pathway activation restrains colitis

Lee

Rothenberg

Seeley

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Inflammation disrupts tissue architecture and function, thereby contributing to the pathogenesis of diverse diseases; the signals that promote or restrict tissue inflammation thus represent potential targets for therapeutic intervention. Here, we report that genetic or pharmacologic Hedgehog pathway inhibition intensifies colon inflammation (colitis) in mice. Conversely, genetic augmentation of Hedgehog response and systemic small-molecule Hedgehog pathway activation potently ameliorate colitis and restrain initiation and progression of colitis-induced adenocarcinoma. Within the colon, the Hedgehog protein signal does not act directly on the epithelium itself, but on underlying stromal cells to induce expression of IL-10, an immune-modulatory cytokine long known to suppress inflammatory intestinal damage. IL-10 function is required for the full protective effect of small-molecule Hedgehog pathway activation in colitis; this pharmacologic augmentation of Hedgehog pathway activity and stromal IL-10 expression are associated with increased presence of CD4+Foxp3+ regulatory T cells. We thus identify stromal cells as cellular coordinators of colon inflammation and suggest their pharmacologic manipulation as a potential means to treat colitis.

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“…It is important to accurately evaluate intestinal mucosa infl ammation in the management of these patients, particularly for the assessment of therapeutic effectiveness. Colonoscopy and biopsy are useful in the assessment of intestinal mucosa inflammation of patients with UC, but these examinations can be a heavy burden to the patient [2,3] . Clinical evaluations including laboratory tests such as C-reactive protein (CRP) [4][5][6] , erythrocyte sedimentation rate (ESR) [7] , acid glycoprotein (AGP) [8] , and platelet count [9,10] , have been used for the determination of disease activity of UC, but none of them are specifi c for gut infl ammation [11] .…”

Section: Introductionmentioning

confidence: 99%

Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

Xiang¹,

Ouyang²,

Li³

et al. 2008

WJG

101

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AIM:To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC). METHODS:The enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS:The fecal calprotectin concentration in the patients with active UC was signifi cantly higher than that in the inactive UC and in the controls (402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P < 0.01).The fecal calprotectin concentration in the inactive UC group was signifi cantly higher than that in the control group (P < 0.05). A signifi cant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUC ROC ) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001). CONCLUSION:Calprotectin in the patient's feces can refl ect the disease activity of UC and can be used as a rational fecal marker for intestinal infl ammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonlyused markers such as CRP, ESR and AGP.

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A reproducible grading scale for histological assessment of inflammation in ulcerative colitis

Cited by 815 publications

References 24 publications

Proinflammatory cytokines and IL-10 in inflammatory bowel disease and colorectal cancer patients

Proinflammatory cytokines and IL-10 in inflammatory bowel disease and colorectal cancer patients

Control of inflammation by stromal Hedgehog pathway activation restrains colitis

Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

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