Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis : a retrospective pilot study
BACKGROUND/AIMS: Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood.
METHODS: This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group).
RESULTS: We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%-93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011).
CONCLUSIONS: Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
Intestinal research - 22(2024), 1 vom: 07. Jan., Seite 92-103 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Akiyama, Shintaro [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 10.02.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5217/ir.2023.00105 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368162346 |
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| 100 | 1 | |a Akiyama, Shintaro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis |b a retrospective pilot study |
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| 520 | |a BACKGROUND/AIMS: Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood | ||
| 520 | |a METHODS: This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group) | ||
| 520 | |a RESULTS: We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%-93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011) | ||
| 520 | |a CONCLUSIONS: Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Phenotype | |
| 650 | 4 | |a Pouchitis | |
| 650 | 4 | |a Sulfomucin: Goblet cells | |
| 650 | 4 | |a Ulcerative colitis | |
| 700 | 1 | |a Onoda, Tsubasa |e verfasserin |4 aut | |
| 700 | 1 | |a Moue, Shoko |e verfasserin |4 aut | |
| 700 | 1 | |a Sakamoto, Noriaki |e verfasserin |4 aut | |
| 700 | 1 | |a Sakamoto, Taku |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Hideo |e verfasserin |4 aut | |
| 700 | 1 | |a Enomoto, Tsuyoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Matsubara, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Oda, Tatsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuchiya, Kiichiro |e verfasserin |4 aut | |
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