Giuseppe Leoncini1, Vincenzo Villanacci2, Maria Grazia Marin3, Valentina Crisafulli2, Moris Cadei2, Elisabetta Antonelli4, Claudio Leoci5, Gabrio Bassotti6,7. 1. Pathology Unit, ASST del Garda, Desenzano del Garda (Brescia), Brescia, Italy. 2. Pathology Unit, ASST Spedali Civili, Brescia, Italy. 3. Department of Laboratory Medicine, ASST del Garda, Desenzano del Garda (Brescia), Brescia, Italy. 4. Gastroenterology Unit, Perugia General Hospital, Perugia, Italy. 5. Department of Gastroenterology and Digestive Endoscopy, ASST del Garda, Desenzano del Garda (Brescia), Brescia, Italy. 6. Gastroenterology, Hepatology and Digestive Endoscopy Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy. gabassot@tin.it. 7. Clinica di Gastroenterologia ed Epatologia, Ospedale S.Maria della Misericordia, Piazzale Menghini, 1, 06156, Perugia, Italy. gabassot@tin.it.
Abstract
BACKGROUND: Although glucocorticosteroids (GS) and mesalazine are effective and widely employed to treat moderate-to-severe ulcerative colitis (UC), information regarding the factors responsible for response to such therapy is still scarce. One of these factors is thought to be an increased number of mucosal eosinophils. The aim of our study was to determine whether the presence of hypereosinophilia in colonic mucosa of UC patients might influence the short-term response to l treatment with GS and mesasalazine. METHODS: Clinical, endoscopic, and pathologic data from patients with a recent diagnosis of moderate UC, who had not undergone treatment, were obtained, and the short-term outcome after 1 month of conventional first-line treatment (mesalazine plus GS) was evaluated. RESULTS: There were 53 patients with a median age of 37 years (95% CI 30-47).Overall, at the end of treatment period 16 (30%) patients responded, whereas a response was not observed in the other 37 (70%) patients. Interestingly, all patients of this latter group had colonic mucosal hypereosinophilia. No significant differences were found between the two groups concerning sex and age at diagnosis, but hypereosinophilia was inversely correlated with the duration of the disease (p = 0.054), and significantly correlated to the localization of UC (p = 0.0023). In addition, The Mayo score was significantly higher in patients with hypereosinophilia (median 8; 95% CI 8-9;) when compared to patients without hypereosinophilia (median 7; 95% CI 7-7, p < 0.0001) including the Mayo endoscopic subscore (median 3; 95% CI 2-3 vs median 2; 95% CI 2-2, respectively; p = 0.007). CONCLUSIONS: The presence of colonic mucosal hypereosinophilia may be useful to predict the short-term outcome to conventional first-line therapy in treatment-naïve UC patients. It remains to be seen whether this might be important in modifying the first-line therapy in this subgroup of patients.
BACKGROUND: Although glucocorticosteroids (GS) and mesalazine are effective and widely employed to treat moderate-to-severe ulcerative colitis (UC), information regarding the factors responsible for response to such therapy is still scarce. One of these factors is thought to be an increased number of mucosal eosinophils. The aim of our study was to determine whether the presence of hypereosinophilia in colonic mucosa of UCpatients might influence the short-term response to l treatment with GS and mesasalazine. METHODS: Clinical, endoscopic, and pathologic data from patients with a recent diagnosis of moderate UC, who had not undergone treatment, were obtained, and the short-term outcome after 1 month of conventional first-line treatment (mesalazine plus GS) was evaluated. RESULTS: There were 53 patients with a median age of 37 years (95% CI 30-47).Overall, at the end of treatment period 16 (30%) patients responded, whereas a response was not observed in the other 37 (70%) patients. Interestingly, all patients of this latter group had colonic mucosal hypereosinophilia. No significant differences were found between the two groups concerning sex and age at diagnosis, but hypereosinophilia was inversely correlated with the duration of the disease (p = 0.054), and significantly correlated to the localization of UC (p = 0.0023). In addition, The Mayo score was significantly higher in patients with hypereosinophilia (median 8; 95% CI 8-9;) when compared to patients without hypereosinophilia (median 7; 95% CI 7-7, p < 0.0001) including the Mayo endoscopic subscore (median 3; 95% CI 2-3 vs median 2; 95% CI 2-2, respectively; p = 0.007). CONCLUSIONS: The presence of colonic mucosal hypereosinophilia may be useful to predict the short-term outcome to conventional first-line therapy in treatment-naïve UC patients. It remains to be seen whether this might be important in modifying the first-line therapy in this subgroup of patients.
Authors: Alexander C Ford; Charles N Bernstein; Khurram J Khan; Maria T Abreu; John K Marshall; Nicholas J Talley; Paul Moayyedi Journal: Am J Gastroenterol Date: 2011-03-15 Impact factor: 10.864
Authors: O Saitoh; K Kojima; K Sugi; R Matsuse; K Uchida; K Tabata; K Nakagawa; M Kayazawa; I Hirata; K Katsu Journal: Am J Gastroenterol Date: 1999-12 Impact factor: 10.864
Authors: Lori A Coburn; Sara N Horst; Rupesh Chaturvedi; Caroline T Brown; Margaret M Allaman; Brooks P Scull; Kshipra Singh; M Blanca Piazuelo; Maithili V Chitnavis; Mallary E Hodges; Michael J Rosen; Christopher S Williams; James C Slaughter; Dawn B Beaulieu; David A Schwartz; Keith T Wilson Journal: PLoS One Date: 2013-12-18 Impact factor: 3.240