Morphological Classification of Corrupted Colonic Crypts in Ulcerative Colitis

Rubio, Carlos A.; Schmidt, Peter T.

doi:10.21873/anticanres.12469

Cited by 6 publications

(6 citation statements)

References 37 publications

(34 reference statements)

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“…The results of this study showed that the majority (about two thirds) of the routine colon biopsies in German patients with UC displayed ≥80% CCC. These findings substantiate the previous deep-rooted subjective impression that the majority of the routine biopsies in Swedish patients with UC (14,15) displayed CCC. Since the vast majority of the routine control biopsies with inflammation also displayed CCC, it was suggested that an unnoticed, consequent, and systematic cutting technical hitch was introduced during the laboratory processing of colon biopsies at the two geographically disparate laboratories (Sweden and Germany).…”

Section: Discussionsupporting

confidence: 89%

“…In previous studies of rectal biopsies (13,14) and colon biopsies in Swedish patients with UC (10,15) we empirically estimated that the majority of the biopsies displayed cross-cut crypts. The pertinent question was: could the histological processing of routine sections be the result of a technical hitch while transferring the biopsy from the forceps to the fixation vial or by wax-bedding and tissue sectioning procedures used at the Swedish laboratory?…”

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confidence: 99%

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Is the Routine Histopathologic Diagnosis of Ulcerative Colitis Based on Cross-cut Sections or on Well-oriented Sections?

RUBIO¹,

Lang-Schwarz²

2023

CDP

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ackground/Aim: For many years, it was empirically estimated that the majority of the routine colon biopsies in Swedish patients with ulcerative colitis (UC), exhibited cross-cut crypts. The aim of the present study was to assess the frequency of cross-cut crypts (CCC) and well-oriented crypts in routine colon biopsies in German patients with UC. Patients and Methods: In total, 447 colon biopsies: 376 with UC and 71 controls were investigated. Results: Out of 376 colon biopsies with UC, 73% exhibited ≥60% CCC. Out of the 237 biopsies showing ≥80% CCC, as many as 71% exhibited 100% CCC in individual biopsies. Similar percentages were found in control biopsies. Conclusion: The majority of the routine colon biopsies with UC, as well as control biopsies in German patients displayed CCC. Thus, an unnoticed, consequent, and systematic cutting technical hitch was introduced during the laboratory processing of colon biopsies. The reason(s) behind the similar histologic processing mode of colon biopsies at the two geographically disparate laboratories (Sweden and Germany) remains elusive. The cross-cutting mode influenced the narrative of biopsies in UC, inasmuch as some histological parameters listed among well-oriented colon sections were not present in sections displaying CCC.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Is the Routine Histopathologic Diagnosis of Ulcerative Colitis Based on Cross-cut Sections or on Well-oriented Sections?

RUBIO¹,

Lang-Schwarz²

2023

CDP

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“…Normal colonic mucosa are made up of epithelial cells with folds called crypts, which are consistent throughout the colon [65,66]. Crypt renewal occurs at the bottom of the crypts where intestinal stem cells generate cell proliferation and differentiation, and thus replenish the epithelium [65][66][67]. In colitis, however, inflammation ultimately causes crypt disruption and architectural irregularities [65,66].…”

Section: Cell Proliferationmentioning

confidence: 99%

“…Crypt renewal occurs at the bottom of the crypts where intestinal stem cells generate cell proliferation and differentiation, and thus replenish the epithelium [65][66][67]. In colitis, however, inflammation ultimately causes crypt disruption and architectural irregularities [65,66]. Vitamin D has been shown to promote mucosal regeneration through the modulation of signaling pathways, including VDR [65] (Table 2).…”

Section: Cell Proliferationmentioning

confidence: 99%

Effects of Vitamin D Supplementation on Inflammation, Colonic Cell Kinetics, and Microbiota in Colitis: A Review

et al. 2020

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Vitamin D is widely known to regulate bone health, but there is increasing evidence that it may also ameliorate colitis through inflammation, cell proliferation and apoptosis, and the microbiota. The purpose of this review is to systematically examine the mechanisms by which vitamin D reduces colitis. PubMed and Web of Science were searched for articles published between 2008 and 2019 using key words such as “vitamin D,” “colitis,” “inflammatory bowel disease,” “inflammation,” “apoptosis,” “cell proliferation,” and “gut bacteria”. Retrieved articles were further narrowed and it was determined whether their title and abstracts contained terminology pertaining to vitamin D in relation to colitis in human clinical trials, animal studies, and cell culture/biopsy studies, as well as selecting the best match sorting option in relation to the research question. In total, 30 studies met the established criteria. Studies consistently reported results showing that vitamin D supplementation can downregulate inflammatory pathways of COX-2, TNF-α, NF-κB, and MAPK, modify cell kinetics, and alter gut microbiome, all of which contribute to an improved state of colitis. Although vitamin D and vitamin D analogs have demonstrated positive effects against colitis, more randomized, controlled human clinical trials are needed to determine the value of vitamin D as a therapeutic agent in the treatment of colitis.

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“…However, none of the aforementioned grading systems includes the histologic characteristics of branching crypts in UC. In previous publications, we described in detail, the histologic characteristics of crypt branching in UC (13)(14)(15)(16). These studies, based on single colonic biopsies in patients with UC showed two histologic phenotypes of branching crypts: i) crypts in symmetric branching (CSB) and ii) crypts in asymmetric branching (CAB).…”

mentioning

confidence: 99%

Crypts in Asymmetric Branching in Patients With Ulcerative Colitis in Remission

Rubio

Lang-Schwarz

2022

Anticancer Res

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Background/Aim: To report the frequency of crypts in asymmetric branching (CAB) in biopsies from all colorectal segments in patients with ulcerative colitis in remission (UCR). Patients and Methods: Biopsies in 100 UC patients were investigated: 50 with UCR and 50 with ongoing long-lasting UC (LLU; i.e., controls). Results: The frequency of CAB was significantly lower in UCR than in LLUC, both in the right colon and left colorectum. CAB frequency was not influenced by two important confounders: the age and sex of patients. Conclusion: CAB is a pathologic aberration of colorectal cryptogenesis evoked by chronic mucosal inflammation. When chronic inflammation waned in UCR, the production of CAB plummeted or ceased. Chronic inflammation and protracted disease-duration in LLUC increase the risk for colorectal dysplasia or carcinoma. Importantly, dysplastic CAB were recently detected in LLUCassociated dysplasia. Whether the abrogation of CAB is instrumental in reducing the neoplastic risk in UCR patients, deserves further investigation.In patients with ulcerative colitis (UC), colorectal endoscopic biopsies show, in addition to increased numbers of inflammatory cells, crypts with architectural distortions and branching crypts (1, 2). Crypt-branching in rectal biopsies from patients with UC was first mentioned by Morson in 1972 (3). Subsequently, Cheng et al. (4) found high

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Morphological Classification of Corrupted Colonic Crypts in Ulcerative Colitis

Abstract: Abstract. Background

Cited by 6 publications

References 37 publications

Is the Routine Histopathologic Diagnosis of Ulcerative Colitis Based on Cross-cut Sections or on Well-oriented Sections?

Is the Routine Histopathologic Diagnosis of Ulcerative Colitis Based on Cross-cut Sections or on Well-oriented Sections?

Effects of Vitamin D Supplementation on Inflammation, Colonic Cell Kinetics, and Microbiota in Colitis: A Review

Crypts in Asymmetric Branching in Patients With Ulcerative Colitis in Remission

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