Confocal laser endomicroscopy in ulcerative colitis: beyond endoscopic assessment of disease activity

Maione, Francesco; Giglio, Mariano Cesare; Luglio, Gaetano; Rispo, Antonio; D’Armiento, Maria; Manzo, Benedetta; Cassese, Gianluca; Schettino, Pietro; Gennarelli, Nicola; Siciliano, S; D'Armiento, F P; Palma, Giovanni Domenico De

doi:10.1007/s10151-017-1654-4

Cited by 9 publications

(12 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In particular, the increase in FLCM in UC patients compared to CD patients might reflect an increased vascular permeability in UC patients, which is a parameter that had not been assessed in a study comparing UC and CD patients [12]. Conversely, the reduced vascular length observed in UC versus CD patients is concordant with vascular alterations described in previous UC studies [3,15,17]. Some of the discriminative parameters between CD and UC patients reported in our study were also identified by Tontini et al [12].…”

Section: Discussionsupporting

confidence: 55%

“…Ultimately, CLE might help not only to target biopsies in order to perform a differential diagnosis between CD and UC cases in indeterminate colitis patients [12] but also to predict disease evolution [13], monitor response to treatment [14] and screen for residual inflammation in macroscopically normal mucosa of treated patients [15,16]. Furthermore, parameters gained with CLE, such as the shape of the crypts, microvascular alteration and fluorescein leakage, have been identified [17], and scores have been proposed to predict relapse and/or assess residual inflammatory activity of IBD [3,4,18,19]. However, these scores are based on semi-quantitative observer-dependent analysis of images, and therefore, creating novel methods and scores allowing diagnosis in IBD is needed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative assessment of mucosal architecture using computer-based analysis of confocal laser endomicroscopy in inflammatory bowel diseases

Quénéhervé

David

Bourreille

et al. 2019

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of mucosal architecture using computer-based analysis of confocal laser endomicroscopy in inflammatory bowel diseases

Quénéhervé

David

Bourreille

et al. 2019

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

show abstract

“…Confocal laser endomicroscopy has been used to determine the degree of inflammation in UC [10]. The advantage of CLE is that it can reflect colonic crypts, epithelial gaps, epithelial leakiness to fluorescein and the microcirculation of mucosal blood flow in vivo [11].…”

Section: Discussionmentioning

confidence: 99%

Papaverine adjuvant therapy for microcirculatory disturbance in severe ulcerative colitis complicated with CMV infection: a case report

Tian

Zheng

Dong

et al. 2019

Clin J Gastroenterol

View full text Add to dashboard Cite

Ulcerative colitis has hypercoagulable state and high risk of thrombosis; so mucosal disturbance of microcirculation may be mediate and amplify the inflammation of ulcerative colitis. A 56-year-old female patient was admitted in hospital for discontinuously mucous bloody stool for more than 1 year. Ulcerative colitis was determined after colonoscopy and pathologic examination. Mesalazine was effective during the year, but her symptoms recurred three times due to her bad compliance. One month before admission, the patient had severe recurrence after mesalazine withdrawal. At this time, the result of quantitative fluorescence PCR of colonic histic CMV-DNA was 1.6 × 104 copies/mL positive, CMV colitis was accompanied. After 4 weeks of ganciclovir and 6 weeks of mesalazine usage and nutrition support, the symptoms of diarrhea and abdominal cramp did not improve; stool frequency was more than twenty times a day. Probe-based confocal laser endomicroscopy revealed local microcirculation disturbance. Papaverine 90-mg slow drip for at least 10 h a day was added. The symptoms dramatically disappeared after 3 days of papaverine treatment. The patient had yellow mushy stool 2–3 times a day. Pathological findings showed diffuse submucosal hemorrhage and transparent thrombosis in capillaries. Treatment of microcirculatory disturbance in severe UC is a promising adjuvant therapy. Confocal laser endomicroscopy may be an effective method for microcirculation judgment.

show abstract

“…More, the diagnostic potential of CLE can be further enhanced by the use of contrast agents (e.g., the fluorescein) that can also be linked to peptides which will selectively link to dysplastic cells or even to antibodies which will allow the visualization of inflamed areas, expressing specific cytokine patterns [85]. Thus, the horizons of CLE might potentially expand towards the early detection of preneoplastic lesions and also the assessment of the inflammatory activity in inflammatory bowel disease (IBD) [86].…”

Section: Future Perspectives and Role Of Confocal Laser Endomicrosmentioning

confidence: 99%

Serrated Lesions of the Colon-Rectum: A Focus on New Diagnostic Tools and Current Management

Cassese

Amendola

Maione

et al. 2019

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Prompt diagnosis and correct management of the so called “serrated lesions” (SLs) of the colon-rectum are generally considered of crucial importance in the past years, mainly due to their histological heterogeneity and peculiar clinical and molecular patterns; sometimes, they are missed at conventional endoscopy and are possibly implicated in the genesis of interval cancers. The aim of this review is to focus on the diagnostic challenges of serrated lesions, underlying the role of both conventional endoscopy and novel technologies. We will show how an accurate and precise diagnosis should immediately prompt the most appropriate therapy other than defining a proper follow-up program. It will be emphasized how novel endoscopic techniques may provide better visualization of mucosal microsurface structures other than enhancing the microvascular architecture, in order to better define and characterize specific patterns of mucosal lesions of the gastrointestinal tract. Standard therapy of SLs of the colon-rectum is still very debated, also due to the relatively lack of studies focusing on treatment issues. The high risk of incomplete resection, together with the high rate of postcolonoscopy interval cancers, suggests the need of an extra care when facing this kind of lesions. Given this background, we will outline useful technical tips and tricks in the resection of SLs, taking aspects such as the size and location of the lesions, as well as novel available techniques and technologies, other than future perspectives, including confocal laser endomicroscopy into consideration. Follow-up of SLs is another hot topic, also considering that their clinical impact has been misunderstood for a long time. The incidence of the so called interval colorectal cancer underlines how some weaknesses exist in current screening and follow-up programs. Considering the lack of wide consensus for the management of some SLs, we will try to summarize and clarify the best strategies for their optimal management.

show abstract

Confocal laser endomicroscopy in ulcerative colitis: beyond endoscopic assessment of disease activity

Abstract: The aim of this study was to investigate the role of confocal laser endomicroscopy (CLE) in the assessment of disease activity in ulcerative colitis (UC)

Cited by 9 publications

References 38 publications

Quantitative assessment of mucosal architecture using computer-based analysis of confocal laser endomicroscopy in inflammatory bowel diseases

Quantitative assessment of mucosal architecture using computer-based analysis of confocal laser endomicroscopy in inflammatory bowel diseases

Papaverine adjuvant therapy for microcirculatory disturbance in severe ulcerative colitis complicated with CMV infection: a case report

Serrated Lesions of the Colon-Rectum: A Focus on New Diagnostic Tools and Current Management

Contact Info

Product

Resources

About