Microscopic colitis patients have increased proportions of Ki67+ proliferating and CD45RO+ active/memory CD8+ and CD4+8+ mucosal T cells

Kumawat, Ashok Kumar; Strid, Hilja; Elgbratt, Kristina; Tysk, Curt; Bohr, Johan; Hörnquist, Elisabeth Hultgren

doi:10.1016/j.crohns.2012.08.014

Cited by 37 publications

(37 citation statements)

References 38 publications

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“…These findings were corroborated by multicolor flow-cytometric analysis of isolated IELs and lamina propria lymphocytes, demonstrating increased proportions of CD4 + and CD8 + colonic lymphocytes expressing CD45RO and Ki67, albeit to different degrees 74. Within the CD8 + IEL population, the proportion of CD45RO + cells showed a trend toward a significant increase in patients with CC, but not LC.…”

Section: Etiology and Pathogenesismentioning

confidence: 56%

“…Within the CD8 + IEL population, the proportion of CD45RO + cells showed a trend toward a significant increase in patients with CC, but not LC. The CD8 + IELs also demonstrated a significantly enhanced proportion of Ki67 + cells in CC, but not LC patients 74. In contrast, no significant changes in the proportions of these populations were found within the CD4 + IELs.…”

Section: Etiology and Pathogenesismentioning

confidence: 78%

“…In contrast, no significant changes in the proportions of these populations were found within the CD4 + IELs. Within the lamina propria, the proportions of CD8 + as well as CD4 + T cells expressing CD45RO or Ki67 were both increased in CC patients, with a trend toward significant increases in LC patients, except the proportions of Ki67 + CD4 + lamina propria T cells, which were significantly enhanced also in LC patients 74. Furthermore, increased proportions of CD4 + 8 + double-positive IELs were seen in CC, and a trend toward increased proportions in LC, as well as in lamina propria lymphocytes in both CC and LC.…”

Section: Etiology and Pathogenesismentioning

confidence: 90%

“…In contrast, MC presents with heavy infiltration of CD8 + IELs 71–74. Using immunohistochemistry, a significant increase in the amount of CD8 + T lymphocytes was found in the epithelium in both LC and CC patients compared to controls, with the most pronounced increase found in LC.…”

Section: Etiology and Pathogenesismentioning

confidence: 93%

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Diagnosis and management of microscopic colitis: current perspectives

Bohr¹,

Wickbom²,

Hegedus³

et al. 2014

CEG

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Collagenous colitis and lymphocytic colitis, together constituting microscopic colitis, are common causes of chronic diarrhea. They are characterized clinically by chronic nonbloody diarrhea and a macroscopically normal colonic mucosa where characteristic histopathological findings are seen. Previously considered rare, they now have emerged as common disorders that need to be considered in the investigation of the patient with chronic diarrhea. The annual incidence of each disorder is five to ten per 100,000 inhabitants, with a peak incidence in 60- to 70-year-old individuals and a predominance of female patients in collagenous colitis. The etiology and pathophysiology are not well understood, and the current view suggests an uncontrolled mucosal immune reaction to various luminal agents in predisposed individuals. Clinical symptoms comprise chronic diarrhea, abdominal pain, fatigue, weight loss, and fecal incontinence that may impair the patient’s health-related quality of life. An association is reported with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. The best-documented treatment, both short-term and long-term, is budesonide, which induces clinical remission in up to 80% of patients after 8 weeks’ treatment. However, after successful budesonide therapy is ended, recurrence of clinical symptoms is common, and the best possible long-term management deserves further study. The long-term prognosis is good, and the risk of complications, including colonic cancer, is low. We present an update of the epidemiology, pathogenesis, diagnosis, and management of microscopic colitis.

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Section: Etiology and Pathogenesismentioning

confidence: 56%

Section: Etiology and Pathogenesismentioning

confidence: 78%

Section: Etiology and Pathogenesismentioning

confidence: 90%

Section: Etiology and Pathogenesismentioning

confidence: 93%

See 2 more Smart Citations

Diagnosis and management of microscopic colitis: current perspectives

Bohr¹,

Wickbom²,

Hegedus³

et al. 2014

CEG

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“…The differences in mucosal lymphocyte subsets seen in patients with collagenous and lymphocytic colitis [19] is not fully understood presently. This information may help us to understand the inflammatory mechanisms involved and may be useful for future therapeutic approaches.…”

Section: Etiopathogenesismentioning

confidence: 99%

Microscopic colitis: Common cause of unexplained nonbloody diarrhea

Ingle

Adgaonkar

Ingle

2014

WJGP

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Microscopic colitis (MC) is characterized by chronic, watery, secretory diarrhea, with a normal or near normal gross appearance of the colonic mucosa. Biopsy is diagnostic and usually reveals either lymphocytic colitis or collagenous colitis. The symptoms of collagenous colitis appear most commonly in the sixth decade. Patients report watery, nonbloody diarrhea of a chronic, intermittent or chronic recurrent course. With collagenous colitis, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa, and with lymphocytic colitis, an increased number of intraepithelial lymphocytes. Histological workup can confirm a diagnosis of MC and distinguish the two distinct histological forms, namely, collagenous and lymphocytic colitis. Presently, both forms are diagnosed and treated in the same way; thus, the description of the two forms is not of clinical value although this may change in the future. Since microscopic colitis was first described in 1976 and only recently recognized as a common cause of diarrhea, many practicing physicians may not be aware of this entity. In this review, we outline the epidemiology, risk factors associated with MC, its etiopathogenesis, the approach to diagnosis and the management of these individuals.

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