Increased CD8+ intraepithelial lymphocyte infiltration and reduced surface area to volume ratio in the duodenum of patients with ulcerative colitis

Francesca Vidali, Antonio Di Sabatino, Francesco Broglia, Paolo Cazzola, Paolo Biancheri, Francesca Torello Viera, Alessandro Vanoli, Costanza Alvisi, Maurizio Perego, Gino R. Corazza

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Abstract

Objective. Recent evidence suggests the involvement of the upper gastrointestinal tract in ulcerative colitis (UC). By conducting a prospective controlled study, we explored the immunological abnormalities in the duodenal mucosa of UC patients. Methods. Duodenal and colonic biopsies were collected from 24 corticosteroid-free UC patients and 21 controls. Colonization by Helicobacter pylori and positivity for anti-endomysial antibodies was an exclusion criteria. The severity of duodenal and colonic inflammation was determined by endoscopic and histologic scores. Morphometry was performed to measure the surface area to volume ratio (SV). Duodenal CD3+ and CD8+ intraepithelial lymphocytes (IELs) and lamina propria mononuclear cells (LPMCs) were detected by immunohistochemistry. Results. Fifteen UC patients and 14 controls were Helicobacter pylori and anti-endomysial antibody negative and were thus included in the study. Microscopic duodenitis was reported in 4 of the 15 UC patients (26.6%), and in none of the controls. A significantly higher number of CD3+ and CD8+ IELs and LPMCs was found in UC patients than in controls. A significant positive correlation between the percentage of both CD3+ and CD8+ IELs and disease activity was found in UC patients. SV was significantly reduced in UC patients compared to controls, and inversely correlated with the percentage of CD8+ IELs. Conclusions. The duodenum of UC patients is infiltrated by a higher number of CD8+ IELs which correlates with the degree of villous flattening and disease activity, but not with extent of the colonic lesions. Further studies are needed to clarify whether the duodenum is a target organ in UC.

Original languageEnglish
Pages (from-to)684-689
Number of pages6
JournalScandinavian Journal of Gastroenterology
Volume45
Issue number6
DOIs
Publication statusPublished - Jun 2010

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Ulcerative Colitis
Duodenum
Lymphocytes
Mucous Membrane
Helicobacter pylori
Anti-Idiotypic Antibodies
Duodenitis
Upper Gastrointestinal Tract
Adrenal Cortex Hormones
Immunohistochemistry
Prospective Studies
Inflammation
Biopsy

Keywords

  • CD3
  • Duodenitis
  • Lamina propria mononuclear cell
  • Morphometry

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{c51de7d1a1e24257beecc38d98445e35,
title = "Increased CD8+ intraepithelial lymphocyte infiltration and reduced surface area to volume ratio in the duodenum of patients with ulcerative colitis",
abstract = "Objective. Recent evidence suggests the involvement of the upper gastrointestinal tract in ulcerative colitis (UC). By conducting a prospective controlled study, we explored the immunological abnormalities in the duodenal mucosa of UC patients. Methods. Duodenal and colonic biopsies were collected from 24 corticosteroid-free UC patients and 21 controls. Colonization by Helicobacter pylori and positivity for anti-endomysial antibodies was an exclusion criteria. The severity of duodenal and colonic inflammation was determined by endoscopic and histologic scores. Morphometry was performed to measure the surface area to volume ratio (SV). Duodenal CD3+ and CD8+ intraepithelial lymphocytes (IELs) and lamina propria mononuclear cells (LPMCs) were detected by immunohistochemistry. Results. Fifteen UC patients and 14 controls were Helicobacter pylori and anti-endomysial antibody negative and were thus included in the study. Microscopic duodenitis was reported in 4 of the 15 UC patients (26.6{\%}), and in none of the controls. A significantly higher number of CD3+ and CD8+ IELs and LPMCs was found in UC patients than in controls. A significant positive correlation between the percentage of both CD3+ and CD8+ IELs and disease activity was found in UC patients. SV was significantly reduced in UC patients compared to controls, and inversely correlated with the percentage of CD8+ IELs. Conclusions. The duodenum of UC patients is infiltrated by a higher number of CD8+ IELs which correlates with the degree of villous flattening and disease activity, but not with extent of the colonic lesions. Further studies are needed to clarify whether the duodenum is a target organ in UC.",
keywords = "CD3, Duodenitis, Lamina propria mononuclear cell, Morphometry",
author = "Francesca Vidali and {Di Sabatino}, Antonio and Francesco Broglia and Paolo Cazzola and Paolo Biancheri and Viera, {Francesca Torello} and Alessandro Vanoli and Costanza Alvisi and Maurizio Perego and Corazza, {Gino R.}",
year = "2010",
month = "6",
doi = "10.3109/00365521003663662",
language = "English",
volume = "45",
pages = "684--689",
journal = "Scandinavian Journal of Gastroenterology",
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TY - JOUR

T1 - Increased CD8+ intraepithelial lymphocyte infiltration and reduced surface area to volume ratio in the duodenum of patients with ulcerative colitis

AU - Vidali, Francesca

AU - Di Sabatino, Antonio

AU - Broglia, Francesco

AU - Cazzola, Paolo

AU - Biancheri, Paolo

AU - Viera, Francesca Torello

AU - Vanoli, Alessandro

AU - Alvisi, Costanza

AU - Perego, Maurizio

AU - Corazza, Gino R.

PY - 2010/6

Y1 - 2010/6

N2 - Objective. Recent evidence suggests the involvement of the upper gastrointestinal tract in ulcerative colitis (UC). By conducting a prospective controlled study, we explored the immunological abnormalities in the duodenal mucosa of UC patients. Methods. Duodenal and colonic biopsies were collected from 24 corticosteroid-free UC patients and 21 controls. Colonization by Helicobacter pylori and positivity for anti-endomysial antibodies was an exclusion criteria. The severity of duodenal and colonic inflammation was determined by endoscopic and histologic scores. Morphometry was performed to measure the surface area to volume ratio (SV). Duodenal CD3+ and CD8+ intraepithelial lymphocytes (IELs) and lamina propria mononuclear cells (LPMCs) were detected by immunohistochemistry. Results. Fifteen UC patients and 14 controls were Helicobacter pylori and anti-endomysial antibody negative and were thus included in the study. Microscopic duodenitis was reported in 4 of the 15 UC patients (26.6%), and in none of the controls. A significantly higher number of CD3+ and CD8+ IELs and LPMCs was found in UC patients than in controls. A significant positive correlation between the percentage of both CD3+ and CD8+ IELs and disease activity was found in UC patients. SV was significantly reduced in UC patients compared to controls, and inversely correlated with the percentage of CD8+ IELs. Conclusions. The duodenum of UC patients is infiltrated by a higher number of CD8+ IELs which correlates with the degree of villous flattening and disease activity, but not with extent of the colonic lesions. Further studies are needed to clarify whether the duodenum is a target organ in UC.

AB - Objective. Recent evidence suggests the involvement of the upper gastrointestinal tract in ulcerative colitis (UC). By conducting a prospective controlled study, we explored the immunological abnormalities in the duodenal mucosa of UC patients. Methods. Duodenal and colonic biopsies were collected from 24 corticosteroid-free UC patients and 21 controls. Colonization by Helicobacter pylori and positivity for anti-endomysial antibodies was an exclusion criteria. The severity of duodenal and colonic inflammation was determined by endoscopic and histologic scores. Morphometry was performed to measure the surface area to volume ratio (SV). Duodenal CD3+ and CD8+ intraepithelial lymphocytes (IELs) and lamina propria mononuclear cells (LPMCs) were detected by immunohistochemistry. Results. Fifteen UC patients and 14 controls were Helicobacter pylori and anti-endomysial antibody negative and were thus included in the study. Microscopic duodenitis was reported in 4 of the 15 UC patients (26.6%), and in none of the controls. A significantly higher number of CD3+ and CD8+ IELs and LPMCs was found in UC patients than in controls. A significant positive correlation between the percentage of both CD3+ and CD8+ IELs and disease activity was found in UC patients. SV was significantly reduced in UC patients compared to controls, and inversely correlated with the percentage of CD8+ IELs. Conclusions. The duodenum of UC patients is infiltrated by a higher number of CD8+ IELs which correlates with the degree of villous flattening and disease activity, but not with extent of the colonic lesions. Further studies are needed to clarify whether the duodenum is a target organ in UC.

KW - CD3

KW - Duodenitis

KW - Lamina propria mononuclear cell

KW - Morphometry

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DO - 10.3109/00365521003663662

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JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

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