Histologic assessments in ulcerative colitis: the evidence behind a new endpoint in clinical trials

Histologic Disease Persists beyond Mucosal Healing and Could Predict Reactivation in Ulcerative Colitis

“…However, in long-term follow-up, some patients relapsed despite the achievement of endoscopic MH. In fact, beyond MH, patients with histologic healing showed better outcomes, with a lesser use of corticosteroid, a lower colon rectal cancer risk, and fewer colectomies [16]. Based on this data, histologic healing has been recently proposed as a different and more ambitious therapeutic target in UC [23,24].…”

“…Eosinophilic cryptitis means the presence of at least one eosinophil in the crypt epithelium; however, an eosinophilic crypt abscess is characterized by the presence of these cells within a crypt lumen in the absence of luminal neutrophils [15]. As of the present, within the context of UC, a standardized definition of histological healing remains controversial [16]. Nonetheless, data have reported that the minimum requirement for histological healing seems to be the resolution of the crypt architectural distortion and of inflammatory infiltrate [12].…”

“…Nonetheless, data have reported that the minimum requirement for histological healing seems to be the resolution of the crypt architectural distortion and of inflammatory infiltrate [12]. Furthermore, several studies over the years have shown a high correlation between histological healing, reduction of length of hospitalization, the possibility of relapse, and a lesser use of corticosteroid [16,17]. However, the question of whether specific histological lesions can predict reactivation in patients with MH is unclear.…”