Nejvíce citovaný článek - PubMed ID 28216137
Low predictive value of histopathological scoring system for complications development in children with Crohn's disease
Inflammatory bowel diseases (IBD) are systemic immune-mediated conditions with predilection for the gastrointestinal tract and include Crohn's disease and ulcerative colitis. Despite the advances in the fields of basic and applied research, the etiopathogenesis remains largely unknown. As a result, only one third of the patients achieve endoscopic remission. A substantial portion of the patients also develop severe clinical complications or neoplasia. The need for novel biomarkers that can enhance diagnostic accuracy, more precisely reflect disease activity, and predict a complicated disease course, thus, remains high. Genomic and transcriptomic studies contributed substantially to our understanding of the immunopathological pathways involved in disease initiation and progression. However, eventual genomic alterations do not necessarily translate into the final clinical picture. Proteomics may represent a missing link between the genome, transcriptome, and phenotypical presentation of the disease. Based on the analysis of a large spectrum of proteins in tissues, it seems to be a promising method for the identification of new biomarkers. This systematic search and review summarize the current state of proteomics in human IBD. It comments on the utility of proteomics in research, describes the basic proteomic techniques, and provides an up-to-date overview of available studies in both adult and pediatric IBD.
- Klíčová slova
- Crohn’s disease, inflammatory bowel disease, pediatric, proteome, proteomics, ulcerative colitis,
- MeSH
- biologické markery metabolismus MeSH
- Crohnova nemoc * metabolismus MeSH
- dítě MeSH
- dospělí MeSH
- idiopatické střevní záněty * metabolismus MeSH
- lidé MeSH
- proteomika metody MeSH
- ulcerózní kolitida * metabolismus MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- biologické markery MeSH
Advances in diagnostics of inflammatory bowel diseases (IBD) and improved treatment strategies allowed the establishment of new therapeutic endpoints. Currently, it is desirable not only to cease clinical symptoms, but mainly to achieve endoscopic remission, a macroscopic normalization of the bowel mucosa. However, up to one-third of IBD patients in remission exhibit persisting microscopic activity of the disease. The evidence suggests a better predictive value of histology for the development of clinical complications such as clinical relapse, surgical intervention, need for therapy escalation, or development of colorectal cancer. The proper assessment of microscopic inflammatory activity thus became an important part of the overall histopathological evaluation of colonic biopsies and many histopathological scoring indices have been established. Nonetheless, a majority of them have not been validated and no scoring index became a part of the routine bioptic practice. This review summarizes a predictive value of microscopic disease activity assessment for the subsequent clinical course of IBD, describes the most commonly used scoring indices for Crohn's disease and ulcerative colitis, and comments on current limitations and unresolved issues.
- Klíčová slova
- Crohn’s disease, Microscopy, Predictor, Score, Ulcerative colitis,
- MeSH
- Crohnova nemoc * farmakoterapie MeSH
- endoskopie škodlivé účinky MeSH
- idiopatické střevní záněty * komplikace MeSH
- lidé MeSH
- střevní sliznice diagnostické zobrazování patologie MeSH
- ulcerózní kolitida * patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Diagnosis of pediatric inflammatory bowel diseases (IBD) remains challenging. We aimed at the value of immunohistochemical assessment of CD30+ lymphocytes in the intestinal mucosa in differential diagnosis between pediatric Crohn's disease (CD) and ulcerative colitis (UC) and its utility as a predictor of future differentiation in patients with IBD unclassified (IBDU). METHODS: Seventy-four treatment naive pediatric patients with IBD (33 CD, 30 UC and 11 IBDU) were enrolled into the study. Biopsy samples from six different regions (terminal ileum, cecum, ascending colon, transverse colon, descending colon and rectum) were immunohistochemically stained with anti-CD30 antibody, and the number of positive cells per one high power field was quantified. RESULTS: Significant differences between CD and UC were found when compared total counts of CD30+ cells in median numbers, mean values and maximal numbers and also for separate counts in terminal ileum, transverse colon, descending colon and rectum. The most profound difference between CD and UC was shown for total median values of CD30+ cells and for the values in rectal localization. The difference was independent on the intensity of inflammation. A cutoff value of 2.5 CD30+ cells with sensitivity 83% and specificity 90% was found for the rectum. There was no difference between patients with CD and IBDU, but a marked difference between UC and IBDU patients was revealed. CONCLUSION: Histopathological assessment of biopsy with rectal CD30+ count is reliable and simple method that could help in differential diagnosis among IBD subtypes in children with IBD.
- Klíčová slova
- CD30, Immunohistochemistry, Inflammatory bowel disease,
- MeSH
- antigen Ki-1 analýza MeSH
- biologické markery analýza MeSH
- Crohnova nemoc diagnóza imunologie patologie MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- imunohistochemie * MeSH
- lidé MeSH
- lymfocyty imunologie patologie MeSH
- mladiství MeSH
- prediktivní hodnota testů MeSH
- předškolní dítě MeSH
- reprodukovatelnost výsledků MeSH
- retrospektivní studie MeSH
- střevní sliznice imunologie patologie MeSH
- ulcerózní kolitida diagnóza imunologie patologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- antigen Ki-1 MeSH
- biologické markery MeSH