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Polymorphonuclear neutrophil leucocytes in childhood Crohn's disease: a morphological study
D C Lewis1, J A Walker-Smith, A D Phillips
1Queen Elizabeth Hospital for Children, London, United Kingdom.
Insights
Neutrophils are involved in childhood Crohn's disease, migrating into the gut and interacting with bacteria and enterocytes. This study used microscopy to observe neutrophil activity in pediatric inflammatory bowel disease.
Area of Science:
- Gastroenterology
- Immunology
- Pediatric Pathology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) affecting children.
- The role of neutrophils in the pathogenesis of pediatric CD requires further elucidation.
Purpose of the Study:
- To investigate the involvement and behavior of neutrophils in the ileum and colon of children with Crohn's disease.
- To explore neutrophil interactions with luminal bacteria and enterocytes in pediatric IBD.
Main Methods:
- Light and electron microscopy were utilized.
- Analysis of surgical resections and endoscopic biopsies from 15 children with Crohn's disease.
- Comparison with cases of ulcerative colitis, E. coli colitis, and healthy controls.
Main Results:
- Demonstrated significant neutrophil infiltration of the lamina propria and epithelium in pediatric CD.
- Observed neutrophil migration into the gut lumen via epithelial breaks and intact epithelium.
- Documented neutrophil phagocytosis of luminal and lamina propria bacteria, and intracellular neutrophils within enterocytes.
- Similar findings were noted in ulcerative colitis and E. coli colitis, but not in controls.
Conclusions:
- Neutrophils play a key role in childhood Crohn's disease.
- Neutrophil response in CD appears to be directed against luminal enterobacteria and enterocytes.
- Microscopic evidence supports neutrophil involvement in the pathology of pediatric IBD.
Abstract:
Light and electron microscopy was applied to surgical resections and endoscopic biopsies from the ileum and colon of 15 children with Crohn's disease in order to investigate the involvement of neutrophils in the disease process. Clear evidence was found of neutrophil infiltration of the lamina propria and epithelium, neutrophil migration into the gut lumen through epithelial breaks and intact epithelium, neutrophil phagocytosis of luminal and lamina propria bacteria, and the presence of intracellular neutrophils in enterocytes. Similar findings were seen in 5 of 6 children with ulcerative colitis and in a case of an E. coli colitis, but not in 8 controls. The observations demonstrate the involvement of neutrophils in Crohn's disease in childhood and suggest that the response is directed, in part, against luminal enterobacteria and enterocytes.