Abstract
Raman spectroscopy was used to differentiate between mucosally healed (or quiescent) and inflamed colon tissue, as assessed endoscopically, in patients with ulcerative colitis. From the analysis of the Raman spectra of 60 biopsy tissue samples, clear differences were identified between the spectra of the quiescent and inflamed tissue. Three carotenoid peaks were found to be approximately twice as intense in the inflamed tissue. Two phospholipid peaks were found to be significantly lower in the inflamed tissue. Using multivariate statistical analysis, we show that these five peaks can be used to discriminate between endoscopically quiescent and inflamed tissue. We also correlated the Raman data with a histological assessment of the tissue. Four of the five peaks were found to be significantly different between the spectra of histologically healed (or quiescent) and histologically inflamed tissue. These findings indicate the ability of Raman spectroscopy to accurately classify colon tissue as either quiescent or inflamed, irrespective of whether an endoscopic or histological grading scheme is followed. We thus demonstrate that Raman spectroscopy could potentially be used as an early diagnosis tool for assessing the presence of mucosal healing or inflammation in patients with ulcerative colitis.
Highlights
Ulcerative colitis (UC) is a chronic inflammatory condition, which is diagnosed in patients worldwide, irrespective of ethnicity and anthropological origin, and is becoming more prevalent with time
An emerging goal of gastroenterology is to establish whether mucosal healing (MH) has occurred in patients treated for UC, as MH appears to lead to favourable outcomes for the patient
A spectroscopic tool which could assist current techniques such as endoscopy and histopathology in examining colonic mucosa for evidence of MH would be of great benefit
Summary
Ulcerative colitis (UC) is a chronic inflammatory condition, which is diagnosed in patients worldwide, irrespective of ethnicity and anthropological origin, and is becoming more prevalent with time. UC is of unknown aetiology, characterised by diffuse and confluent mucosal inflammation of the colon, starting from the rectum with a characteristic relapsing and remitting course [2]. 25% of patients with UC experience acute exacerbation of their disease activity during the course of their disease [3]. The colectomy rate increases with more than one hospital admission with acute severe UC reaching up to 40% after two admissions [3]. The treatment goals in UC focus on keeping the disease in remission and a colectomy free survival. A critical part of the assessment of UC is the definition of what constitutes clinical remission
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