Rectal mucosal plasma cells in inflammatory bowel disease.

Abstract

SUMMARY To achieve optimum staining and reproducible counts of plasma cells in paraffin embedded tissue with the immunoperoxidase technique we have found it essential to obtain a plateau count by titration of antisera for each specimen. This modification was used to study IgA, IgM, IgE, and IgG plasma cells in rectal biopsies from 20 controls, 20 patients with ulcerative proctocolitis, 20 with Crohn's colitis, 20 with non-specific proctitis, 15 with bacterial colitis, and seven with Crohn's disease but no apparent large bowel involvement. Counts were correlated with the characteristic histological features of inflammatory bowel disease. In controls the ratio of the mean counts for IgA, IgM, IgE, and IgG plasma cells was 8:3:3:1. All types of plasma cells were very significantly increased in the patients with ulcerative proctocolitis, Crohn's colitis, and non-specific proctitis and counts correlated with the severity of inflammation. There was no significant difference between the counts in these three groups. All counts tended to be higher in bacterial colitis than in controls, the difference being significant for IgA and IgE. When matched for severity of inflammation there was no significant difference between the counts in bacterial colitis and inflammatory bowel disease. The counts in patients with Crohn's disease but no large bowel involvement were not significantly different from controls. These results suggest that changes in plasma cell counts in inflammatory bowel disease are a non-specific reponse to mucosal damage, possibly by a luminal irritant, and do not differentiate the type of inflammatory bowel disease.Ulcerative proctocolitis and Crohn's colitis are common diseases of unknown aetiology in which imunological mechanisms play a part. The differentiation of these two conditions, although often very difficult, is of practical importance in relation to both medical and surgical treatment. Non-specific proctitis is usually considered a mild variant of ulcerative proctocolitis but there are a number of differences,l which suggest they might be separate conditions. Changes in the total and differential rectal mucosal plasma cell counts have been reported in all three conditions.2~9 The different studies have given strikingly conflicting results, however, and there is even great variation between the results in control groups.3 %8 1012 There are probably several reasons for the conflicting results. One is the small numbers of patients studied -for controls the average number is nine, for ulcerative

Influence of treatment on morphological features of mucosal inflammation

“…A pronounced difference in plasma cell counts between normal and chronically inflamed rectal mucosa has indeed been noted. 31 This was confirmed in a prospective blind evaluation of multiple colon mucosal biopsy specimens from patients with CD and UC. Basal plasmacytosis was present in more than half of the IBD patients.…”

Immunological study of histologically non-involved jejunum during Crohn's disease: evidence for reduced in vivo secretion of secretory IgA

“…Many immunohistochemieal studies have shown an increase in Ig-eontaining cells (IgG, IgA, IgM) in the lamina propria of the diseased mucosa (Skinner & Whitehead 1974;Baklien & Brandtzaeg 1975 Correspondence: J. C. Rambaud, MD, Hopital Saint-Lazare, 107 bis, rue du faubourg Saint-Denis, 75010 Paris, France. Rosekrans et al, 1980;Scott et al, 1983;Keren et al, 1984). Recently, studies of Ig synthesis and secretion in vitro by mononuclear eells isolated from involved sites demonstrated reduced IgA and increased IgG synthesis and secretion (Bookman&Bull 1979;MacDermottera/., 1981MacDermottera/., ,1986Danis, Harries & Heatley 1984;Scott et al, 1986;Verspaget et al, 1988;Wu et al, 1989).…”

Humoral reaction in the inflamed colon in Hirschsprung's disease and ulcerative colitis.

“…Scott et al showed a general increase in immunoglobulin and could not distinguish between different types of inflammatory bowel disease by this method. 9 Fewer studies have concentrated on local antibody production in Hirschsprung's disease. Wijesinha and Steer looked at the dysfunctional bowel in children with necrotising colitis and Hirschsprung's disease who had had a proximal colostomy, and compared the number of immunoglobulin containing cells in the proximal and distal colon.…”