Intestinal Research

Original Articles

Inflammatory bowel diseases

Quantitative histology-based classification system for assessment of the intestinal mucosal histological changes in patients with celiac disease: Prasenjit Das, Gaurav PS Gahlot, Alka Singh, Vandana Baloda, Ramakant Rawat, Anil K Verma, Gaurav Khanna, Maitrayee Roy, Archana George, Ashok Singh, Aasma Nalwa, Prashant Ramteke, Rajni Yadav, Vineet Ahuja, Vishnubhatla Sreenivas, Siddhartha Datta Gupta, Govind K Makharia; Intest Res 2019;17(3):387-397. Published online April 22, 2019; DOI: https://doi.org/10.5217/ir.2018.00167

Background/Aims
The existing histological classifications for the interpretation of small intestinal biopsies are based on qualitative parameters with high intraobserver and interobserver variations. We have developed and propose a quantitative histological classification system for the assessment of intestinal mucosal biopsies.
Methods
We performed a computer-assisted quantitative histological assessment of digital images of duodenal biopsies from 137 controls and 124 patients with celiac disease (CeD) (derivation cohort). From the receiver-operating curve analysis, followed by multivariate and logistic regression analyses, we identified parameters for differentiating control biopsies from those of the patients with CeD. We repeated the quantitative histological analysis in a validation cohort (105 controls and 120 patients with CeD). On the basis of the results, we propose a quantitative histological classification system. The new classification was compared with the existing histological classifications for interobserver and intraobserver agreements by a group of qualified pathologists.
Results
Among the histological parameters, intraepithelial lymphocyte count of ≥25/100 epithelial cells, adjusted villous height fold change of ≤0.7, and crypt depth-to-villous height ratio of ≥0.5 showed good discriminative power between the mucosal biopsies from the patients with CeD and those from the controls, with 90.3% sensitivity, 93.5% specificity, and 96.2% area under the curve. Among the existing histological classifications, our quantitative histological classification showed the highest intraobserver (69.7%–85.03%) and interobserver (24.6%–71.5%) agreements.
Conclusions
Quantitative assessment increases the reliability of the histological assessment of mucosal biopsies in patients with CeD. Such a classification system may be used for clinical trials in patients with CeD. (Intest Res, Published online)

Citations

Citations to this article as recorded by

Follow-up of Celiac Disease After Diagnosis
Luca Elli, Govind K. Makharia, Daniel A. Leffler, Lucia Scaramella, Georgia Malamut
Gastrointestinal Endoscopy Clinics of North America.2025;[Epub] CrossRef
Celiac Disease Deep Learning Image Classification Using Convolutional Neural Networks
Joaquim Carreras
Journal of Imaging.2024; 10(8): 200. CrossRef
CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease
James Denholm, Benjamin A Schreiber, Florian Jaeckle, Mike N Wicks, Emyr W Benbow, Tim S Bracey, James Y H Chan, Lorant Farkas, Eve Fryer, Kishore Gopalakrishnan, Caroline A Hughes, Kathryn J Kirkwood, Gerald Langman, Betania Mahler-Araujo, Raymond F T Mc
BMJ Open Gastroenterology.2024; 11(1): e001252. CrossRef
Role of Serology, Dietary Assessment, and Fecal Gluten Immunogenic Peptides for Predicting Histologic Recovery in Children with Celiac Disease
Keerthivasan Seetharaman, Sadhna Bhasin Lal, Kaushal Kishor Prasad, Yashwant Kumar, Alka Bhatia, Sunita Malhotra
Digestive Diseases and Sciences.2023; 68(2): 529. CrossRef
Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
Raghav Lal, Ranjeet Bhardwaj, Ranjana Walker Minz, Kaushal Kishore Prasad, Sadhna Lal, Devi Dayal, Yashwant Kumar
Pediatrics & Neonatology.2023; 64(4): 388. CrossRef
The global burden of coeliac disease: opportunities and challenges
Govind K. Makharia, Prashant Singh, Carlo Catassi, David S. Sanders, Daniel Leffler, Raja Affendi Raja Ali, Julio C. Bai
Nature Reviews Gastroenterology & Hepatology.2022; 19(5): 313. CrossRef
Gluten Induces Subtle Histological Changes in Duodenal Mucosa of Patients with Non-Coeliac Gluten Sensitivity: A Multicentre Study
Kamran Rostami, Arzu Ensari, Michael N. Marsh, Amitabh Srivastava, Vincenzo Villanacci, Antonio Carroccio, Hamid Asadzadeh Aghdaei, Julio C. Bai, Gabrio Bassotti, Gabriel Becheanu, Phoenix Bell, Camillo Di Bella, Anna Maria Bozzola, Moris Cadei, Giovanni
Nutrients.2022; 14(12): 2487. CrossRef
The Role of Nerve Fibers in the Tumor Immune Microenvironment of Solid Tumors
Sharia Hernandez, Alejandra G. Serrano, Luisa M. Solis Soto
Advanced Biology.2022;[Epub] CrossRef
Case Report: Morphologic and Functional Characteristics of Intestinal Mucosa in a Child With Short Bowel Syndrome After Treatment With Teduglutide: Evidence in Favor of GLP-2 Analog Safety
Enrico Costantino Falco, Antonella Lezo, Pierluigi Calvo, Caterina Rigazio, Anna Opramolla, Ludovica Verdun, Giovanna Cenacchi, Marianna Pellegrini, Marco Spada, Gabriella Canavese
Frontiers in Nutrition.2022;[Epub] CrossRef
Quantitative histology as a diagnostic tool for celiac disease in children and adolescents
Mateus M. Vargas, Ricardo Artigiani Neto, Vera L. Sdepanian
Annals of Diagnostic Pathology.2022; 61: 152031. CrossRef
Best practices of handling, processing, and interpretation of small intestinal biopsies for the diagnosis and management of celiac disease: A joint consensus of Indian association of pathologists and microbiologists and Indian society of gastroenterology
Prasenjit Das, Kim Vaiphei, AnjaliD Amarapurkar, Puja Sakhuja, Ritambhra Nada, RoopaRachel Paulose, Rachana Chaturvedi, Anuradha Sekaran, Usha Kini, Archana Rastogi, Niraj Kumari, Anna Pulimood, Mala Banerjee, Prateek Kinra, Lavleen Singh, AmarenderSingh
Indian Journal of Pathology and Microbiology.2021; 64(5): 8. CrossRef
Artificial intelligence in small intestinal diseases: Application and prospects
Yu Yang, Yu-Xuan Li, Ren-Qi Yao, Xiao-Hui Du, Chao Ren
World Journal of Gastroenterology.2021; 27(25): 3734. CrossRef
Opportunities and challenges in the management of celiac disease in Asia
Ashish Agarwal, Ashish Chauhan, Vineet Ahuja, Govind K Makharia
JGH Open.2020; 4(5): 795. CrossRef
Digital histology in celiac disease: A practice changer
Daniel Vasile Balaban, Mariana Jinga
Artificial Intelligence in Gastroenterology.2020; 1(1): 1. CrossRef
Digital histology in celiac disease: A practice changer
Daniel Vasile Balaban, Mariana Jinga
Artificial Intelligence in Gastroenterology.2020; 1(1): 1. CrossRef

8,660 View
183 Download
13 Web of Science
15 Crossref

IBD

Selective M1 macrophage polarization in granuloma-positive and granuloma-negative Crohn's disease, in comparison to intestinal tuberculosis: Prasenjit Das, Ritika Rampal, Sonakshi Udinia, Tarun Kumar, Sucharita Pilli, Nahid Wari, Imtiaz Khan Ahmed, Saurabh Kedia, Siddhartha Datta Gupta, Dhiraj Kumar, Vineet Ahuja; Intest Res 2018;16(3):426-435. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.426

Abstract PDF PubReader ePub

Background/Aims

Classical M1 macrophage activation exhibits an inflammatory phenotype while alternative M2 macrophage activation exhibits an anti-inflammatory phenotype. We aimed to determine whether there are discriminant patterns of macrophage polarization in Crohn's disease (CD) and intestinal tuberculosis (iTB).

Methods

Colonic mucosal biopsies from 29 patients with iTB, 50 with CD, and 19 controls were examined. Dual colored immunohistochemistry was performed for iNOS/CD68 (an M1_φ marker) and CD163/CD68 (an M2_φ marker), and the ratio of M1_φ to M2_φ was assessed. To establish the innate nature of macrophage polarization, we analyzed the extent of mitochondrial depolarization, a key marker of inflammatory responses, in monocyte-derived macrophages obtained from CD and iTB patients, following interferon-γ treatment.

Results

M1_φ polarization was more prominent in CD biopsies (P=0.002) than in iTB (P=0.2) and control biopsies. In granuloma-positive biopsies, including those in CD, M1_φ predominance was significant (P=0.001). In iTB, the densities of M1_φ did not differ between granuloma-positive and granuloma-negative biopsies (P=0.1). Interestingly, higher M1_φ polarization in CD biopsies correlated with high inflammatory response exhibited by peripheral blood-derived monocytes from these patients.

Conclusions

Proinflammatory M1_φ polarization was more common in colonic mucosa of CD patients, especially in the presence of mucosal granulomas. Further characterization of the innate immune system could help in clarifying the pathology of iTB and CD.

Citations

Citations to this article as recorded by

Macrophage polarization: an important role in inflammatory diseases
Min Luo, Fukun Zhao, Huan Cheng, Mu Su, Yuanmin Wang
Frontiers in Immunology.2024;[Epub] CrossRef
The gut barrier as a gatekeeper in colorectal cancer treatment
Roy Hajjar, Carole Richard, Manuela M. Santos
Oncotarget.2024; 15(1): 562. CrossRef
New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef
Differentiating gastrointestinal tuberculosis and Crohn's disease- a comprehensive review
Arup Choudhury, Jasdeep Dhillon, Aravind Sekar, Pankaj Gupta, Harjeet Singh, Vishal Sharma
BMC Gastroenterology.2023;[Epub] CrossRef
Clinical Usefulness of Immune Profiling for Differential Diagnosis between Crohn’s Disease, Intestinal Tuberculosis, and Behcet’s Disease
Ji Won Yoo, Su In Jo, Dong Woo Shin, Ji Won Park, Sung-Eun Kim, Hyun Lim, Ho Suk Kang, Sung-Hoon Moon, Min Kyu Kim, Sang-Yeob Kim, Sung Wook Hwang, Jae Seung Soh
Diagnostics.2023; 13(18): 2904. CrossRef
Production of granulomas in Mycoplasma bovis infection associated with meningitis-meningoencephalitis, endocarditis, and pneumonia in cattle
Mathurot Suwanruengsri, Ryoko Uemura, Takuya Kanda, Naoyuki Fuke, Phawut Nueangphuet, Apisit Pornthummawat, Masahiro Yasuda, Takuya Hirai, Ryoji Yamaguchi
Journal of Veterinary Diagnostic Investigation.2022; 34(1): 68. CrossRef
Human M1 macrophages express unique innate immune response genes after mycobacterial infection to defend against tuberculosis
Arshad Khan, Kangling Zhang, Vipul K. Singh, Abhishek Mishra, Priyanka Kachroo, Tian Bing, Jong Hak Won, Arunmani Mani, Ramesha Papanna, Lovepreet K. Mann, Eder Ledezma-Campos, Genesis Aguillon-Duran, David H. Canaday, Sunil A. David, Blanca I. Restrepo,
Communications Biology.2022;[Epub] CrossRef
Lacticaseibacillus casei Strain Shirota Modulates Macrophage-Intestinal Epithelial Cell Co-Culture Barrier Integrity, Bacterial Sensing and Inflammatory Cytokines
Andrew Foey, Neama Habil, Alex Strachan, Jane Beal
Microorganisms.2022; 10(10): 2087. CrossRef
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Haiyuan Xing, Ruiyan Li, Yun'an Qing, Boda Ying, Yanguo Qin
Applied Materials Today.2021; 22: 100969. CrossRef
Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model
Ming-Ko Chiang, Pei-Yi Hsiao, Yen-Yi Liu, Hui-Ling Tang, Chien-Shun Chiou, Min-Chi Lu, Yi-Chyi Lai
Gut Microbes.2021;[Epub] CrossRef
A combination of circulating microRNA-375-3p and chemokines CCL11, CXCL12, and G-CSF differentiate Crohn’s disease and intestinal tuberculosis
Susree Roy, Suchandrima Ghosh, Mallica Banerjee, Sayantan Laha, Dipanjan Bhattacharjee, Rajib Sarkar, Sujay Ray, Arko Banerjee, Ranajoy Ghosh, Aniket Halder, Alakendu Ghosh, Raghunath Chatterjee, Simanti Datta, Gopal Krishna Dhali, Soma Banerjee
Scientific Reports.2021;[Epub] CrossRef
Arsenic trioxide alleviates acute graft-versus-host disease by modulating macrophage polarization
Xiao Liu, Yan Su, Xueyan Sun, Haixia Fu, Qiusha Huang, Qi Chen, Xiaodong Mo, Meng Lv, Yuan Kong, Lanping Xu, Xiaojun Huang, Xiaohui Zhang
Science China Life Sciences.2020; 63(11): 1744. CrossRef
Heterogeneous macrophages: Supersensors of exogenous inducing factors
Caiyun Qian, Zehui Yun, Yudi Yao, Minghua Cao, Qiang Liu, Song Hu, Shuhua Zhang, Daya Luo
Scandinavian Journal of Immunology.2019;[Epub] CrossRef
Understanding Pathogenesis and Care Challenges of Immune Reconstitution Inflammatory Syndrome in Fungal Infections
Sarah Dellière, Romain Guery, Sophie Candon, Blandine Rammaert, Claire Aguilar, Fanny Lanternier, Lucienne Chatenoud, Olivier Lortholary
Journal of Fungi.2018; 4(4): 139. CrossRef

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14 Crossref

Colorectal neoplasia

Topographic, histological and molecular study of aberrant crypt foci identified in human colon in different clinical groups: Shouriyo Ghosh, Brijnandan Gupta, Pavan Verma, Sreenivas Vishnubathla, Sujoy Pal, Nihar R Dash, Siddhartha Datta Gupta, Prasenjit Das; Intest Res 2018;16(1):116-125. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.116

Abstract PDF PubReader ePub

Background/Aims

Aberrant crypt foci (ACF) are early microscopic lesions of the colonic mucosa, which can be detected by magnified chromoendoscopy. Herein, we have investigated whether ACF identified in different clinical groups can be differentiated based on their characteristics.

Methods

Macroscopically unremarkable mucosal flaps were collected from 270 fresh colectomies and divided into 3 clinical groups: colorectal carcinoma (group A), disease controls having known pre-neoplastic potential (group Bc), and disease controls without risk of carcinoma development (group Bn). Topographic and histologic analysis, immunohistochemistry, and molecular studies (high-resolution melt curve analysis, real-time polymerase chain reaction, and Sanger sequencing) were conducted for certain neoplasia-associated markers.

Results

ACF were seen in 107 cases, out of which 72 were left colonic ACF and 35 right colonic ACF (67.2% vs. 32.7%, P=0.02). The overall density of left colonic ACF was 0.97/cm, which was greater than the right colonic ACF density of 0.81/cm. Hypercrinia was present in 41 out of 72 left colonic ACF and in 14 out of 35 right colonic ACF (P=0.01). Immunohistochemical expression of p53 was also greater in left colonic ACF than in right colonic ACF (60.5% vs. 38.2%, P=0.03). However, ACF identified among the 3 clinical groups did not show any distinguishing topographic, histological, or genetic changes.

Conclusions

Left colonic ACF appear to be high-risk based on their morphological and prototypic tumor marker signature. ACF identified in different clinical groups do not show significant genotypic or topographic differences. Further detailed genetic studies are required to elucidate them further.

Citations

Citations to this article as recorded by

Methylation study of tumor suppressor genes in human aberrant crypt foci, colorectal carcinomas, and normal colon
Jayati Sarangi, Prasenjit Das, Aijaz Ahmad, Mohamed Sulaiman, Shouriyo Ghosh, Brijnandan Gupta, Rajesh Panwar, Sujoy Pal, Rajni Yadav, Vineet Ahuja, Sudip Sen, Asish D. Upadhyay, Nihar R. Dash, Atul Sharma, Siddhartha D. Gupta
Journal of Cancer Research and Therapeutics.2024; 20(1): 268. CrossRef

8,027 View
75 Download
1 Web of Science
1 Crossref

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