Gastroenterologìa (Jun 2023)
Сonnection of immunological markers with morphological manifestations in ulcerative colitis
Abstract
Background. Inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease, are an urgent problem of modern gastroenterology. Therefore, the discovery of new laboratory approaches makes it possible to assess the degree of the disease. Purpose: to reveal the relationship between morphological manifestations and immunological indicators in patients with ulcerative colitis. Materials and methods. The studies were conducted on biological material (blood and colonic biopsy samples) of 90 patients with ulcerative colitis. The thickness of the mucosa, density of the inflammatory infiltrate and its composition, crypt sizes, their architectonics, the presence of crypt abscesses, atrophic and fibrotic changes were calculated in biopsies by morphological and morphometric methods. Immunological studies included the evaluation of mononuclear cells, the levels of B-lymphocytes, interleukin-10, tumor necrosis factor α, immunoglobulins (Ig) A, M, G. Results. The histological activity of the disease was determined by an increased level of inflammatory infiltrate (14,431.4 ± 483.3 per 1 mm2 of stroma) and the presence of many neutrophilic granulocytes (212.2 ± 20.9 per 1 mm2 of stroma) and lymphocytes (2,922.8 ± 76.6 per 1 mm2 of stroma) in it. Also, some patients had crypt abscesses (36.7 % of the total number of patients) and breaches in the epithelial integrity (54.4 % of the total number of patients). A correlation was found between the level of CD22+ lymphocytes and some morphometric parameters: the width of the crypts (r = 0.27; P < 0.01) and the height of the surface epithelium (r = 0.30; P < 0.01); between IgM concentrations and cellular density of mucosal infiltrate (r = 0.29; P < 0.01), neutrophils (r = 0.28; P < 0.01) and basophils (r = 0.24; P < 0.05); level of IgA and macrophages (r = 0.21; P < 0.05), lymphocytes (r = 0.24; P < 0.05), basophils (r = 0.25; P < 0.05). Conclusions. It is shown that some morphological and morphometric indicators are related to immunological parameters. It was found that the elevated level of cytokines correlates with the activity of inflammation in patients with ulcerative colitis. The level of CD22+ lymphocytes and changes in some morphometric indicators (crypt width and surface epithelium height) are directly related to an increase in inflammatory processes in the intestinal mucosa.
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