Association of steroid use with complicated sigmoid diverticulitis: potential role of activated CD68+/CD163+ macrophages

Abstract

Inflammation, especially mediated by activated (CD68+/CD163+) macrophages in histopathological specimen might resemble the cellular link between steroid use and complicated types of sigmoid diverticulitis. Macrophages might be a suitable target for future supportive/preventive therapies. However, as long as we are lacking such strategies, we must bear in mind that steroid intake is a risk factor for complicated diverticulitis, especially when indicating surgical resection.

Gut microbiota, metabolome and immune signatures in patients with uncomplicated diverticular disease

“…These results are interesting in light of previous evidence indicating that macrophage infiltration was a determinant of diverticular disease severity,15 associated with severe diverticulitis,16 predicted diverticulitis recurrence17 and the risk of anastomotic leakage after colonic resection for diverticulitis 18…”

Diverticulitis in immunosuppressed patients: A fatal outcome requiring a new approach?

“…Immunosuppression and steroid intake are known risk factors for perforated diverticulitis. 15,16 Given the fatal outcome of diverticulitis in IS patients, there is a need to reconsider a strategy to reduce mortality. First, it is crucial to establish the correct diagnosis as soon as possible.…”

Lesional Accumulation of CD163-Expressing Cells in the Gut of Patients with Inflammatory Bowel Disease

“…Increased expression of CD163 has been also seen in skin macrophages and peripheral blood monocytes of patients with systemic sclerosis, an autoimmune disease characterized by local inflammatory infiltrates and widespread fibrosis [37]. CD163-expressing macrophages are also overrepresented in the colon of patients with diverticulitis [38] and in the kidney of patients with IgA nephropathy [39].…”