Journal Mobile Options
Table of Contents
Vol. 84, No. 1, 2011
Issue release date: July 2011
Digestion 2011;84:12–21
(DOI:10.1159/000320773)

Submucosal Fibrosis and Basic-Fibroblast Growth Factor-Positive Neutrophils Correlate with Colonic Stenosis in Cases of Ulcerative Colitis

Yamagata M. · Mikami T. · Tsuruta T. · Yokoyama K. · Sada M. · Kobayashi K. · Katsumata T. · Koizumi W. · Saigenji K. · Okayasu I.
aDepartment of Gastroenterology, Kitasato University East Hospital, and bDepartment of Pathology, Kitasato University School of Medicine, Sagamihara, Japan

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background and Aims: The frequency of benign stenosis in ulcerative colitis (UC) is low, reported as being 3.2–11.2%, with fibrosis in the submucosa or deeper pointed out as one of the causes. The aim of the present study was to assess stenosis in UC cases using immunostaining and to analyze differences between stenotic and nonstenotic cases, focusing on basic-fibroblast growth factor (b-FGF) expression and myofibroblasts. Methods: Totals of 9 stenotic and 17 nonstenotic UC cases were histopathologically examined and immunohistochemically stained for b-FGF, α-smooth muscle actin (α-SMA), CD34, CD68 and IL-6. To identify b-FGF-positive cells, double immunostaining for b-FGF and myeloperoxidase or CD68 was performed. Results: In addition to submucosal fibrosis, a significant increase of b-FGF-positive inflammatory cells and myofibroblasts was observed in stenotic portions. Most b-FGF-positive cells were also positive for myeloperoxidase, and a correlation between b-FGF-positive and total neutrophil counts was found. Conclusions: One of the major causes of stenosis in long-standing UC is fibrosis in the bowel wall, possibly induced by infiltrating inflammatory neutrophils producing b-FGF.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Farmer RG: Complications and ulcerative colitis; in Berk JE (ed): Bockus Gastroenterology. Philadelphia, WB Saunders 1995, pp 1357–1363.
  2. Edwards FC, Truelove SC: The course and prognosis of ulcerative colitis. Part 3. Complications. Gut 1964;5:1–15.
  3. De Dombal FT, Watts J, Watkinson G, Goligher J: Local complications of ulcerative colitis: stricture, pseudopolyposis and carcinoma of the colon and rectum. Br Med J 1966;1:1442–1447.
  4. Gumaste V, Sachar DB, Greenstein AJ: Benign and malignant colorectal strictures in ulcerative colitis. Gut 1992;33:938–941.
  5. Uchima Y, Nishiguchi Y, Maeda K, Hirakawa K, Suzuki N: A case of ulcerative colitis with stenosis of ascending colon (in Japanese with English abstract). Nippon Daityoukoumonbyou Gakkai Zasshi 1999;52:321–326.
  6. Morikoshi E, Satou N, Tamegai N: A case of ulcerative colitis where transverse and descending colons had rapidly stenosed and total extirpation of colon was performed (in Japanese with English abstract). Prog Dig Endoscopy 1994;45:208–209.
  7. Oono N, Ihi T, katayama R, Ishida H, Anazawa S, Sakurai K, Matsui T, Ikegami M, Oobuchi N: A case of ulcerative colitis with rectal stricture (in Japanese). Nippon Syoukakibyou Gakkai Zasshi (JJSG) 1989;86:2656.
  8. Gospodarowicz D, Ferrara N, Schweigerer L, Neufeld G: Structural characterization and biological functions of fibroblast growth factor. Endocr Rev 1987;8:95–114.
  9. Taha Y, Raab Y, Larsson A, Carlson M, Lööf L, Gerdin B, Thörn M: Mucosal secretion and expression of basic fibroblast growth factor in patients with collagenous colitis. Am J Gastroenterol 2003;98:2011–2017.
  10. Andoh A, Fujio S, Okuno T, Fujiyama Y, Bamba T: Intestinal subepithelial myofibroblasts in inflammatory bowel diseases. J Gastroenterol 2002;37:33–37.
  11. Zurawski J, Woźniak A, Salwa-Zurawska W, Kaczmarek E, Majewski P: Vascular changes in ulcerative colitis and Leśniowski-Crohn’s disease. Pol J Pathol 2007;58:13–21.

    External Resources

  12. Kobayashi K, Katsumata T, Saigenji K, Yoshizawa S, Sada M: Differential diagnosis between type 4 colorectal cancer and inflammatory bowel disease (in Japanese with English abstract). Stomach Intestine (Tokyo) 2002;37:165–175.
  13. Seo M, Okada M, Yao T, Ueki M, Arima S, Okumura M: An index of disease activity in patients with ulcerative colitis. Am J Gastroenterol 1992;87:971–976.
  14. Seo M, Okada M, Yao T, Okabe N, Maeda K, Oh K: Evaluation of disease activity in patients with moderately active ulcerative colitis: comparisons between a new activity index and Truelove and Witts’ classification. Am J Gastroenterol 1995;90:1759–1763.
  15. Matts SGF: The value of rectal biopsy in the diagnosis of ulcerative colitis. Quart J Med 1961;120:393–407.
  16. Mikami T, Yoshida T, Akino F, Motoori T, Okayasu I: Apoptosis regulation differs between ulcerative colitis-associated and sporadic colonic tumors: association with survivin and Bcl-2. Am J Clin Pathol 2003;119:723–730.
  17. Mikami T, Yoshida T, Shiraishi H, Tokuyama W, Okayasu I: Bottom-up cell proliferation with cyclin A and p27Kip1 expression in ulcerative colitis-associated dysplasia. Pathol Int 2006;56:10–16.
  18. Bousvaros A, Zurakowski D, Fishman SJ, Keough K, Law T, Sun C, Leichtner AM: Serum basic fibroblast growth factor in pediatric Crohn’s disease. Implications for wound healing. Dig Dis Sci 1997;42:378–386.
  19. Wallace K, Burt AD, Wright MC: Liver fibrosis. Biochem J 2008;411:1–18.
  20. Izumi M, Suda K, Torii A, Inadama E: Pancreatic ductal myofibroblasts. Proliferative patterns in various pathologic situations. Virchows Arch 2001;438:442–450.
  21. Chowdhury A, Fukuda R, Fukumoto S: Growth factor mRNA expression in normal colorectal mucosa and in uninvolved mucosa from ulcerative colitis patients. J Gastroenterol 1996;31:353–360.
  22. Inoue Y, King TE Jr, Barker E, Daniloff E, Newman LS: Basic fibroblast growth factor and its receptors in idiopathic pulmonary fibrosis and lymphangioleiomyomatosis. Am J Respir Crit Care Med 2002;166; 765–773.
  23. Thörn M, Raab Y, Larsson A, Gerdin B, Hällgren R: Intestinal mucosal secretion of basic fibroblast growth factor in patients with ulcerlative colitis. Scand J Gastroenterol 2000;35:408–412.
  24. Mudter J, Neurath MF: IL-6 signaling in inflammatory bowel disease: pathophysiological role and clinical relevance. Inflamm Bowel Dis 2007;13:1016–1023.
  25. Li Y, de Haar C, Chen M, Deuring J, Gerrits MM, Smits R, Xia B, Kuipers EJ, van der Woude CJ: Disease-related expression of the IL-6/STAT3/SOCS3 signaling pathway in ulcerative colitis and ulcerative colitis-related carcinogenesis. Gut 2010;59:227–235.
  26. Lee EY, Stenson WF, DeSchryver-Kecskemeti K: Thickening of muscularis mucosae in Crohn’s disease. Mod Pathol 1991;4:87–90.
  27. Graham MF, Diegelmann RF, Elson CO, Lindblad WJ, Gotschalk N, Gay S, Gay R: Collagen content and types in the intestinal strictures of Crohn’s disease. Gastroenterology 1988;94:257–265.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50