The cellular-differential composition of the intestinal epithelium in various phases of inflammatory bowel diseases

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Abstract

BACKGROUND: The steady increase in the number of inflammatory bowel diseases and the absence of reliably significant diagnostic markers require the search for new morphological criteria for differential diagnosis.

AIM: This study aimed to determine the cellular-differential composition of the intestinal epithelium in the phases of exacerbation and remission in Crohn’s disease and ulcerative colitis.

MATERIALS AND METHODS: Tissue samples of 60 patients with inflammatory bowel diseases (Crohn’s disease, n=30; ulcerative colitis, n=30) and with irritable bowel syndrome (control group, n=15) were studied using histological, immunohistochemical, morphometric and statistical methods.

RESULTS: Distinct features of the cellular-differential composition of the epithelium in the mucous membrane of the ileum, ascending colon, sigmoid colon, and rectum were identified across these conditions, with differences observed during exacerbation and remission in inflammatory bowel diseases. The proportion of goblet cells in the epithelial lining varied by intestinal region and disease type and phase.

Goblet cell differentiation: 25.0% more goblet cells of the superficial epithelium between the crypts of the ileum in acute Crohn’s disease compared with remission (p=0.0002); 42.9% more goblet cells in the superficial epithelium of the ascending colon compared with irritable bowel syndrome (p=0.0001); 23.0% more goblet cells crypt in the sigmoid colon compared with ulcerative colitis in the acute stage (p=0.0024). There were no significant differences in the differentiation of Paneth cells. There was a threefold increase in endocrinocytes in the sigmoid colon in acute Crohn’s disease compared with irritable bowel syndrome (p=0.0238).

Nonepithelial differon cells: fewer interepithelial lymphocytes in Crohn’s disease in remission compared with Crohn’s disease in the acute stage by 2.4 times in the sigmoid colon, 4.0 times in the rectum (p <0,0001); compared with irritable bowel syndrome by 4.8 times in the ileum, 2.7 times in the ascending intestine, 4.0 times in the sigmoid colon (p <0,05); 8.0 times in the rectum compared with ulcerative colitis in remission (p=0,0004). Additionally, the study found proliferative activity of crypt cells (mainly goblet-shaped) increased by 4.2 times in the sigmoid colon in acute Crohn’s disease compared with acute ulcerative colitis (p=0,0016).

CONCLUSIONS: Morphometric parameters of the cellular-differential composition of the intestinal epithelium can serve as potential differential diagnostic criteria. Acute Crohn’s disease is characterized by a higher proliferation index in the sigmoid colon compared with acute ulcerative colitis, while Crohn’s disease in remission shows a lower number of interepithelial lymphocytes in the rectum compared with ulcerative colitis in remission.

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About the authors

Liudmila I. Bernardelli

North-Western State Medical University named after I.I. Mechnikov

Email: bernardellimila@gmail.com
ORCID iD: 0000-0001-9077-7718
SPIN-code: 5671-1891

doctor

Russian Federation, 47 Piskarevsky Prospekt, 195067 Saint Petersburg

Fedor A. Indeickin

National Center for Clinical Morphological Diagnostics

Email: f.indeickin@yandex.ru
ORCID iD: 0000-0002-1436-2235
SPIN-code: 4627-4445

doctor of pathological anatomy

Russian Federation, Saint Petersburg

Lilia G. Matyusheva

North-Western State Medical University named after I.I. Mechnikov

Email: liliali2719@gmail.com
ORCID iD: 0000-0003-1746-8059
SPIN-code: 3658-3376

student of the faculty of Preventive Medicine

Russian Federation, 47 Piskarevsky Prospekt, 195067 Saint Petersburg

Alexey M. Emelin

Petrovsky National Research Centre of Surgery

Email: eamar40rn@gmail.com
ORCID iD: 0000-0003-4109-0105
SPIN-code: 5605-1140

doctor of pathological anatomy

Russian Federation, Moscow

Maria I. Skalinskaya

North-Western State Medical University named after I.I. Mechnikov

Email: Mariya.Skalinskaya@szgmu.ru
ORCID iD: 0000-0003-0769-8176
SPIN-code: 2596-5555

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 47 Piskarevsky Prospekt, 195067 Saint Petersburg

Anna S. Nekrasova

North-Western State Medical University named after I.I. Mechnikov

Email: Anna.Nekrasova@szgmu.ru
ORCID iD: 0000-0001-5198-9902
SPIN-code: 7502-5036

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, 47 Piskarevsky Prospekt, 195067 Saint Petersburg

Roman V. Deev

Petrovsky National Research Centre of Surgery

Author for correspondence.
Email: romdey@gmail.com
ORCID iD: 0000-0001-8389-3841
SPIN-code: 2957-1687

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Moscow

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2. Fig. 1. Endocrine cells in the epithelium of the mucous membrane of the rectum, immunohistochemical reaction with antibodies to chromogranin A, staining of nuclei with hematoxylin; ×400: a — irritable bowel syndrome, cytoplasmic reaction; b — Crohn's disease in remission, cytoplasmic reaction; c — Crohn's disease in the acute stage, cytoplasmic reaction; d — ulcerative colitis in remission, cytoplasmic reaction; e — ulcerative colitis in the acute stage, cytoplasmic reaction.

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3. Fig. 2. Interepithelial lymphocytes (МЭЛ) (*) in the epithelium of the mucous membrane of the sigmoid colon, immunohistochemical reaction with antibodies to (CD3), staining of nuclei with hematoxylin; ×1000: a — irritable bowel syndrome, cytoplasmic reaction; b — Crohn's disease remission, membrane reaction, c — Crohn's disease in the acute stage, membrane reaction; d — ulcerative colitis in remission, membrane reaction; e — ulcerative colitis in the acute stage, cytoplasmic reaction; f — diagram; * p <0.05.

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4. Fig. 3. Proliferation in the epithelium of the mucous membrane of the ileum, immunohistochemical reaction with antibodies to Ki-67, staining of nuclei with hematoxylin; ×400: a — irritable bowel syndrome; b — Crohn's disease in remission; c — Crohn's disease in acute stage; d — ulcerative colitis in remission; e — ulcerative colitis in acute stage; f — diagram; * p <0.05.

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