Melanosis Coli in Inflammatory Bowel Disease

Pardi, Darrell S.; Rothenberg, Harold J.; Batts, Kenneth P.

doi:10.1097/00004836-199804000-00003

Cited by 30 publications

(17 citation statements)

References 21 publications

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“…1). Apoptosis of colonic epithelial cells may be stimulated by laxatives of the anthrachinon type, constipation [3,21] or inflammatory bowel disease [16]. Several studies have shown that the pigment is neither melanin nor a pure anthrachinon derivative [3,6,7,22].…”

Section: Introductionmentioning

confidence: 99%

Lack of Pseudomelanosis coli in colonic adenomas suggests different pathways of apoptotic bodies in normal and neoplastic colonic mucosa

Regitnig

Denk

2000

Virchows Archiv

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Pseudomelanosis coli is characterized by pigment deposition in the lamina propria and caused by increased epithelial apoptosis. Pseudomelanosis coli is absent in colonic neoplasia. The aim of our studies was to investigate this phenomenon in more detail. Apoptotic fragments of epithelial cells and their distribution, cell proliferation (Ki-67, MIB 1 immunostaining), macrophages (CD68 immunostaining), Bcl-2 expression and apoptosis [terminal-deoxynucleotidyl-transferase mediated dUTP fluorescein nick end labeling (TUNEL) assay] were studied in adenomas arising in normal and melanotic colonic mucosa, in normal colonic mucosa and colonic mucosa with pseudomelanosis alone. In adenomas, we found 7.0 apoptotic bodies per 100 epithelial cells in the epithelial layer and only 0.2 apoptotic bodies per high power field (HPF) in the lamina propria. In contrast, in melanotic mucosa 1.7 apoptotic bodies per 100 epithelial cells in the epithelial layer and 2.5 per HPF in the lamina propria were found. Our results show that apoptotic fragments remain in the neoplastic (adenomatous) epithelium and do not reach (at least in higher amounts) the lamina propria. They can, therefore, not contribute to the development of pseudomelanosis in these lesions. However, macrophages are diminished in adenomas. Proliferation (Ki-67) and also Bcl-2 expression are highly increased in adenomas. The pathway of mucosal macrophages is also discussed.

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Section: Introductionmentioning

confidence: 99%

Lack of Pseudomelanosis coli in colonic adenomas suggests different pathways of apoptotic bodies in normal and neoplastic colonic mucosa

Regitnig

Denk

2000

Virchows Archiv

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“…The authors concluded that chronic colitis with increased apoptosis could also cause MC without laxative abuse [18]. We did not have a patient with inflammatory bowel disease; one patient had a hardly visible brown discoloration in the caecum.…”

Section: Discussionmentioning

confidence: 92%

Herbal remedies are the main etiologic factor in melanosis coli, a case series study

Kav

Bayraktar

2010

Open Medicine

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AbstractMelanosis coli is a brown to black discoloration of the colon mucosa usually associated with long-term ingestion of laxatives. However, melanosis coli can be found in patients with no history of laxative use. Regular use of herbal remedies could be the major source of anthranoid laxatives in such patients. We designed a prospective case series study to identify the clinical characteristics and etiology of melanosis coli in affected patients. This study took place in Ankara, Turkey, between 08/2005 and 11/2006. Patients with endoscopic diagnosis of melanosis coli were interviewed for demographical data and use of herbal remedies. A total of 380 colonoscopies were performed during this period. Melanosis coli was diagnosed endoscopically in 12 patients (3.17%), 11 of whom were found to have characteristic pigment-laden macrophages in histopathological examination. Herbal remedies were the main etiological factor in the development of melanosis coli in 10 out of 11 patients. Diffuse involvement was found in 2 patients who had a history of long-term use. In 8 patients, melanosis coli was located in the left side of the colon. Although melanosis coli is a harmless discoloration of colonic mucosa resulting from complementary or alternative medicine, we believe that this association with herbals was overlooked or not inquired in patients. Therefore, it should be emphasized that “natural” or “alternative” is not equal to “safe”.

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“…Patches with dense MC infiltration may be observed in the mucosa, but their overall number was decreased, as assessed by immunohistochemistry for tryptase and c-kit, and by TEM. Their metachromicity was often resistant to formalin fixation, they had signs of piecemeal degranulation by TEM and pigment storing mucosal macrophages [37] with tryptasepositive lysosomes [see also ref. 14] were found.…”

Section: Discussionmentioning

confidence: 99%

“…The pigment ( fig. 4d, h), which is characteristic for so-called melanosis coli [37], was absent in ascariasis and displayed a yellow to reddish autofluorescence with the rhodamine filtre combination on formalin-fixed tissue. Furthermore, the MC morphology differed in TB-stained sections.…”

Section: Morphological and Ultrastructural Observations In Ascariasismentioning

confidence: 99%

Selective Alterations in Mast Cell Subsets and Eosinophil Infiltration in Two Complementary Types of Intestinal Inflammation: Ascariasis and Crohn’s Disease

et al. 2002

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Objective: Numbers of mast cells (MCs) of different subpopulations and the extent of eosinophil infiltration were compared in Crohn’s disease and ascariasis. These two types of intestinal inflammation are complementary with regard to T cell response (TH1 versus TH2), prevalence and environmental factors. Methods: Histochemical, immunohistochemical and ultrastructural tools were applied to biopsies of morphologically uninvolved colon, ileum and duodenum from Crohn’s and ascariasis patients, as well as resection margins and tissues from an experimental porcine ascariasis model. MC subsets were defined by their dye-binding properties, and their chymase content was analysed using biochemical tools. Results: The TH2 (IgE-mediated) response in ascariasis was characterised by a dramatic increase in mucosal- type MCs (MMCs) and eosinophils in both the mucosa and the deeper layers of the intestinal wall and a simultaneous decrease of connective tissue-type MCs (CTMCs). Uninvolved intestine of Crohn’s patients showed moderate proliferation of CTMCs in the deeper layers of the intestinal wall, but a significant decrease of the MMCs, associated with moderate eosinophilia in all layers of the gut. Similar changes were present in the uninvolved duodenum of Crohn’s patients. Comparable amounts of chymase could be extracted from mucosal and submucosal duodenum, with similar proportions of its two principal isoforms in each. Conclusions: Our results indicate that T cell responses (TH1 or TH2) are associated with different MC subsets in intestinal inflammation. Changes remote from the focus of inflammation point to the systemic nature of the different MC responses.

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Melanosis Coli in Inflammatory Bowel Disease

Cited by 30 publications

References 21 publications

Lack of Pseudomelanosis coli in colonic adenomas suggests different pathways of apoptotic bodies in normal and neoplastic colonic mucosa

Lack of Pseudomelanosis coli in colonic adenomas suggests different pathways of apoptotic bodies in normal and neoplastic colonic mucosa

Herbal remedies are the main etiologic factor in melanosis coli, a case series study

Selective Alterations in Mast Cell Subsets and Eosinophil Infiltration in Two Complementary Types of Intestinal Inflammation: Ascariasis and Crohn’s Disease

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