Abstract
Crohn's disease (CD) is a chronic autoimmune disease characterized by obstructing intestinal strictures. Conventional imaging modalities can identify the strictures but cannot characterize whether a stricture is predominantly inflammatory or fibrotic. The purpose of this study is to examine the capability of photoacoustic (PA) imaging to characterize intestinal fibrosis and inflammation in vivo. Intestinal strictures in a rat model of CD were imaged with a PA-ultrasound parallel imaging system. Internal and external illuminations were attempted, both with transcutaneous PA signal reception. The PA signal magnitudes acquired at wavelengths targeting individual molecular components and the derived functional information showed significant differences between the inflammatory and fibrotic strictures, consistent with histological inflammation and fibrosis.
Highlights
Crohn’s disease (CD) is a chronic autoimmune disease characterized by obstructing intestinal strictures due to inflammation, fibrosis, or a combination of both [1, 2]
We have previously demonstrated the capability of PA imaging in identifying inflammation and fibrosis in human and animal tissues ex vivo by quantifying the hemoglobin and collagen content, respectively [20]
This study examines the proposed imaging approach as applied to the trinitrobenzene sulfonic acid (TNBS) model of Crohn’s disease in rats [10, 20]
Summary
Crohn’s disease (CD) is a chronic autoimmune disease characterized by obstructing intestinal strictures due to inflammation, fibrosis, or a combination of both [1, 2]. Among the estimated 700,000 CD patients in the United States [3,4,5], 70% suffer from irreversible fibrotic intestinal strictures and require at least one surgical intervention [5]. Since extracellular matrix gene expression (ECM) is a recognized predictor of future complicated disease in CD patients, the measurement of fibrosis in CD determines whether a patient has progression of disease [6]. Accurate measurement of intestinal fibrosis versus inflammation is critical as inflammatory strictures can be treated medically, but late stage fibrotic strictures are irreversible and have to be removed surgically. A noninvasive method to characterize CD strictures will contribute to the therapeutic monitoring and planning for treatment of CD patients [7, 8]
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