Persistence of mucosal abnormality in ulcerative colitis.

Quantification of autofluorescence imaging can accurately and objectively assess the severity of ulcerative colitis

“…However, around half of the patients with symptomatic remission exhibited a high relapse rate when the remission-inducing therapy was switched to maintenance therapy [2][3][4], suggesting that clinical symptoms are not a sufficient indicator to determine the status of the intestinal inflammation. The findings of CE were also reported to be an insufficient indicator for predicting the histological inflammation in quiescent UC [23][24][25][26], while the conventional endoscopic findings are strongly correlated with the histological severity in active UC [27]. The inter-observer consistency of the conventional endoscopic assessment on UC is not sufficient (kappa value=0.61 to 0.80) because of the diversity of the findings [11,12].…”

“…The conventional endoscopic findings are closely associated with the histological severity in an active stage of UC [5]. However, there are a couple of reports that conventional endoscopy (CE) underestimates the severity of UC [6][7][8][9][10]. Furthermore, the inter-observer consistency of the endoscopic assessment by UC is not regarded to be sufficient enough, because the endoscopists have to judge various complicated structures that are present due to the refractory inflammation based on their own experiences [11,12].…”

“…* Mikihiro Fujiya fjym@asahikawa-med.ac.jp when switching from the remission-inducing therapy to the maintenance therapy [2][3][4]. Therefore, endoscopic findings are introduced for assessing the disease activity in addition to clinical symptoms.…”

The efficacy of autofluorescence imaging in the diagnosis of colorectal diseases

“…Such patients exhibited a high relapse rate when switching from a remission-inducing therapy to a maintenance therapy [49][50][51]. Thus, the endoscopic assessment of mucosal inflammation is crucial for determining the therapeutic strategy in UC patients.…”

Mucosal healing as an index of colitis activity: Back to histological healing for future indices

“…Dick et al 9 reviewed 200 cases of UC after a minimum period of 5 years from onset to determine what proportion of mucosal abnormalities persist in the absence of symptoms. Their criteria for abnormal findings included: 1) an abnormal glandular pattern; 2) an excess of chronic inflammatory cells (small round cells and plasma cells); and 3) more than an occasional polymorphonuclear leukocyte.…”