Gaint Cell Microscopic Colitis

[ant]

Dear All

Thought this might be interesting - published Dec 2008 so a little old (and sorry if already posted somewhere).

http://www.informaworld.com/smpp/conten ... mptype=rss

I do not have access to the full paper but here is the abstract.

In red I highlight that "autoimmune diseases" and "gluten sensitivity" are clearly recognized as associated with MC.

Microscopic colitis with giant cells: a clinico-pathological review of 11 cases and comparison with microscopic colitis without giant cells
Authors: Ian S. Brown a; Duncan L. J. Lambie a
Affiliation: a Sullivan and Nicolaides Pathology, Brisbane, Queensland, Australia
DOI: 10.1080/00313020802436394
Published in: journal Pathology, Volume 40, Issue 7 December 2008 , pages 671 - 675
Subject: Pathology;

Abstract

Aim: To document clinical and pathological features of microscopic colitis with giant cells (MCGC) which is one of a number of atypical variants of microscopic colitis.

Methods: Cases of microscopic colitis were assessed for giant cells during routine reporting and retrieved from the slide file at a private laboratory. The histological features and clinical data were assessed. Histochemistry (trichome and haematoxylin van Gieson) and immunohistochemistry (CD68) was performed to characterise the nature of the giant cells.

Results: Giant cells were identified in 11 cases of microscopic colitis. The histological features of MCGC are not significantly different from usual MC except for the presence of multinucleated giant cells in the superficial lamina propria. Apart from the common but not unexpected association with autoimmune disease, no unique clinical features of the MCGC group were identified versus those described in the literature for ordinary MC. Immune disorders included gluten-sensitive enteropathy, systemic lupus erythematosus and raised titres of antinuclear antibodies.

Conclusions: The giant cells have the same immunohistochemical characteristics as histiocytes and appear to form through histiocyte fusion. The presence of giant cells does not appear to confer any further clinical significance and remains a histological curiosity.

Best, Ant

[Lucy]

As an FYI, I think that gluten sensitive enteropathy is used interchangeably with celiac disease. Perhaps it will become more broadly used as the scientific community becomes more aware of the association of M.C. with gs as well as celiac disease. Let's hope so...I like the terminology.

Luce

[ant]

More to link MC and Celiac

Journal of Clinical Pathology 2007;60:382-387 doi:10.1136/jcp.2005.036376

* Original article

Microscopic colitis demonstrates a T helper cell type 1 mucosal cytokine profile

1. Peter P Tagkalidis1,
2. Peter R Gibson2,
3. Prithi S Bhathal1

+ Author Affiliations

1.
1Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia
2.
2Department of Medicine and Department of Gastroenterology, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia

1. Correspondence to:
Dr P Tagkalidis
Department of Gastroenterology, PO Box 2012, Royal Melbourne Hospital, Parkville 3050, Victoria, Australia; peter.tagkalidis@mh.org.au

* Accepted 6 May 2006
* Published Online First 14 June 2006

Abstract

Background: Microscopic colitis (MC) is an inflammatory disorder of unknown aetiology.

Aim: To characterise the mucosal cytokine profile of MC, with a view to understanding its potential pathogenic mechanisms.

Methods: Cytokine profiles of mucosal biopse specimens taken at flexible sigmoidoscopy from 18 patients (8 with lymphocytic colitis and 10 with collagenous colitis) were analysed using real-time reverse transcriptase-PCR, in comparison with those from 13 aged-matched controls with diarrhoea-predominant irritable bowel syndrome. Biopsy specimens from six patients with histologically documented remission were available for comparative analysis. Biopsy specimens were also taken to determine the cellular expression of cytokine and cytokine-related proteins using immunohistochemistry.

Results: Mucosal mRNA levels were 100 times greater for interferon (IFN)γ and interleukin (IL) 15, 60 times greater for tumour necrosis factor α, and 35 times greater for inducible nitric oxide synthase in MC compared with controls. Apart from a trend for increased levels of IL10, levels of other T helper cell type 2 (TH2) cytokines including IL2 and IL4 were too low to be accurately quantified. Mucosal IFNγ mRNA levels correlated with the degree of diarrhoea, and returned to normal in remission. The immunohistochemical expression of cell junction proteins E-cadherin and ZO-1 was reduced in active disease. No differences were noted between lymphocytic and collagenous colitis for any of the above parameters.

Conclusions: MC demonstrates a TH1 mucosal cytokine profile with IFNγ as the predominantly upregulated cytokine, with concurrent induction of nitric oxide synthase and down regulation of IFNγ-related cell junction proteins. This pattern is similar to that in coeliac disease and suggests that it might represent a response to a luminal antigen.

Best, Ant

[tex]

Conclusions: MC demonstrates a TH1 mucosal cytokine profile with IFNγ as the predominantly upregulated cytokine, with concurrent induction of nitric oxide synthase and down regulation of IFNγ-related cell junction proteins. This pattern is similar to that in coeliac disease and suggests that it might represent a response to a luminal antigen.

Excellent observation!

Tex