Background: Ulcerative colitis (UC) is a debilitating inflammatory bowel disease. Present knowledge regarding UC disease progression over time is limited. Objective: To assess UC progression to severe disease along with disease burden and associated factors. Methods: Electronic medical records linked with Swedish national health registries (2005–2015) were used to identify disease progression of UC. Odds of all-cause and disease-related hospitalization within 1 year were compared between patients with disease progression and those without. Annual indirect costs were calculated based on sick leave, and factors related to UC progression were examined. Results: Of the 1,361 patients with moderate UC, 24% progressed to severe disease during a median of 5.2 years. Severe UC had significantly higher odds for all-cause (OR [odds ratio] 1.47, 95% CI [confidence interval]: 1.12–1.94, P < 0.01) and UC-related hospitalization (OR 2.47, 95% CI: 1.76–3.47, P < 0.0001) compared to moderate disease. Average sick leave was higher in patients who progressed compared to those who did not (64.4 vs 38.6 days, P < 0.001), with higher indirect costs of 151,800 SEK (16,415 €) compared with 92,839 SEK (10,039 €) (P < 0.001), respectively. UC progression was related to young age (OR 1.62, 95% CI: 1.17–2.25, P < 0.01), long disease duration (OR 1.09, 95% CI: 1.03–1.15, P < 0.001), and use of corticosteroids (OR 2.49, 95% CI: 1.67–3.72, P < 0.001). Conclusion: Disease progression from moderate to severe UC is associated with more frequent and longer hospitalizations and sick leave. Patients at young age with long disease duration and more frequent glucocorticosteroid medication are associated with progression to severe UC.

The biological activities of C(60)-bis(N,N-dimethylpyrrolidinium iodide), a water-soluble cationic fullerene derivative, on human promyeloleukaemia (HL-60) cells were investigated. The pyrrolidinium fullerene derivative showed cytotoxicity in HL-60 cells. The characteristics of apoptosis, such as DNA fragmentation and condensation of chromatin in HL-60 cells, were observed by exposure to the pyrrolidinium fullerene derivative. Caspase-3 and -8 were activated and cytochrome c was also released from mitochondria. The generation of reactive oxygen species (ROS) by the pyrrolidinium fullerene derivative was observed by DCFH-DA, a fluorescence probe for the detection of ROS. Pre-treatment with alpha-tocopherol suppressed cell death and intracellular oxidative stress caused by the pyrrolidinium fullerene derivative. The apoptotic cell death induced by the pyrrolidinium fullerene derivative was suggested to be mediated by ROS generated by the pyrrolidinium fullerene derivative.

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IntroductionThe normal count for intraepithelial lymphocytes (IELs)/100 enterocytes in the colon has been defined at 20. Normal eosinophil counts are harder to identify. In the caecum, eosinophils are more numerous and up to 40/high power fields (HPF) is suggested to be normal. Irritable Bowel Syndrome (IBS), by definition is not associated with pathology by microscopy but colonic innate immune disorder is implicated in some patients. The aim of this study was to define cell counts in a normal group of subjects and to compare these in subjects with IBS to ascertain if these may be used as biomarkers.MethodsColonoscopy with biopsies was performed in 742 subjects (mean age 51 years, 45% male) and biopsies taken from ileum (TI), caecum, transverse (TC), sigmoid colon (SC) and rectum (R) with a completed validated questionnaire of GI symptoms from a random population sample in Stockholm. Ethical approval, Karolinska Instititet. A case control study was performed comparing 90 normal subjects and 100 subjects with IBS, subtyped,(defined by Rome III criteria) to count IELs/100 enterocytes and eosinophils/5 HPF at each site in biopsies stained by H&E. Sections were examined by two observers. For each section the number of IELs/100 enterocytes was counted, and the number of eosinophils counted in five non-overlapping HPF.ResultsOf 90 control subjects, mean age 52 years, (SD11.4) 53.3% men. Of 100 IBS patients, mean age 46 years (SD13.7) 39% men. In IBS subjects, 17 were classified IBS-C (35% men), 30 with IBS-D (30% men), 13 with IBS-M (15% men), 40 with unsubtyped IBS (58% men). Lin's concordance results for inter-observer variability were 0.94 for IELs and 0.99 for eosinophils. Histopathology in controls and IBS was normal. Cell counts were compared in normal subjects categorised by gender, BMI, age and medications and no significant differences were observed between any categories. Eosinophil counts were highest in the caecum regardless of diagnosis (p<0.05) (Abstract 048).ConclusionThis study has defined normal cell counts for IELs and eosinophils in the TI and colon. No significant differences were found with medication, BMI, age or gender or comparing normal subjects with IBS patients. Abstract PTH-048NormalIELs medianEos medianIBSIELs medianEos medianTI n=6414.59TI n=721714Caecum n=84827Caecum n=97933TC n=87814TC n=99918SC n=9088SC n=951011R n=8673R n=9783

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