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Inflammatory Bowel Diseases: Does One Histological Score Fit All?
Vincenzo Villanacci1, Rachele Del Sordo2, Tommaso Lorenzo Parigi3
1Institute of Pathology, ASST-Spedali Civili University of Brescia, 25123 Brescia, Italy.
Diagnostics (Basel, Switzerland)
|June 28, 2023
Summary
Mucosal healing in inflammatory bowel diseases requires confirmed histologic remission. A simplified scoring system focusing on neutrophils offers a more objective assessment for ulcerative colitis and Crohn's disease.
Area of Science:
- Gastroenterology
- Histopathology
- Inflammatory Bowel Disease (IBD) research
Background:
- Mucosal healing (MH) is a primary treatment goal for ulcerative colitis (UC) and Crohn's disease (CD).
- Histologic assessment is crucial for confirming MH but can be subjective and complex.
- Current histological scoring systems for IBD activity vary in complexity and objectivity.
Purpose of the Study:
- To review existing histological scoring systems for IBD.
- To highlight the limitations and subjectivity of current methods.
- To introduce a simplified mucosa healing scheme (SHMHS) based on neutrophil infiltration.
Main Methods:
- Review of existing literature on histological assessment in IBD.
- Analysis of characteristics and limitations of current scoring systems.
- Description of a simplified mucosa healing scheme (SHMHS) focusing on neutrophils.
Main Results:
- Neutrophil infiltration is a key histological marker distinguishing active from quiescent IBD.
- Basal plasmacytosis is a diagnostic clue, not an indicator of disease activity or remission.
- Existing scoring systems are often complex and subjective, necessitating simpler approaches.
Conclusions:
- A simplified mucosa healing scheme (SHMHS) based on neutrophil infiltration offers an objective method for assessing MH in IBD.
- Standardization of disease assessment may be improved by AI models and novel molecular markers.
- Accurate histological assessment is vital for guiding IBD treatment and monitoring outcomes.
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