4475 Clinical usefulness of magnifying endoscopic findings and il-7 mrna expression in remission mucosa for the prediction of recurrence of ulcerative colitis.

Abstract

Background: We have demonstrated the dysregulation of mucosal interleukin-7 (IL-7) mediated immune responses in the colitis lesion of human ulcerative colitis (UC) by using endoscopically biopsied materials.To establish an effective method for the prediction of recurrence of UC, we assessed of magnifying endoscopic findings and IL-7 mRNA expression in remission mucosa of UC. Methods: 1) A magnifying electronic endoscopy Olympus EVIS colonoscopy CF-200HM and CF-240Z that could be used for observation at maximum 100-167 magnification on the monitor were used to assess minute lesions in the rectum mucosa. 2) Mucosal biopsied specimens was obtained from endoscopically normal remission mucosa of UC. IL-7 mRNA expression was assessed by semi-quantitative RT-PCR method. Results: 1) Normal architecture of pits of Liberkuhn glands was visualized in the colonic mucosa by the magnifying colonoscopy after 0.2% indigocarmine or 0.25% methylene blue spraying. 2) In remission UC mucosa, abnormalities of area colonicae were demonstrated by the magnifying colonoscopy, even in the mucosa with normal appearance by conventional colonoscopy. These included redness (81%), microerosions (69%), and irregularity (50%) decreased in number (56%), disordered arrangement (81%) of area colonicae. 3) IL-7 mRNA expression was significantly decreased in actively inflamed mucosa. In contrast, that in remission mucosa varied. In the colonic mucosa from three of ten patients IL-7 mRNA expression was slightly decreased, and not changed in the mucosa of other seven patients. 4) Even in remission UC mucosa with normal appearance by conventional colonoscopy, IL-7 mRNA was decreased in the cases with abnormalities of area colonicae by magnifying colonoscopy. Conclusions: These results indicate that magnifying endoscopic findings in combined with assessing of IL-7 mRNA expression in remission mucosa may be useful for the prediction of recurrence of UC.