TY - JOUR
T1 - Inflammation and tissue remodeling contribute to fibrogenesis in stricturing Crohn's disease
T2 - image processing and analysis study
AU - Arslan, Mustafa Erdem
AU - Brar, Rupinder
AU - Goetz, Lianna
AU - Karamchandani, Dipti
AU - Mikula, Michael W.
AU - Hodge, Kyle
AU - Li, Hua
AU - Ahn, Sangtae
AU - Lee, Hwajeong
N1 - Publisher Copyright:
© 2022 The Korean Society of Pathologists/The Korean Society for Cytopathology.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Inflammation and structural remodeling may contribute to fibrogenesis in Crohn's disease (CD). We quantified the immunoexpression of calretinin, CD34, and calprotectin as a surrogate for mucosal innervation, telocytes (interstitial cells playing a role in networking), and inflammation, respectively, and correlated them with bowel alterations in stricturing CD. Methods: Primary resection specimens for ileal CD (n=44, 31 stricturing CD, 13 inflammatory CD) were identified. Left-sided ulcerative colitis and trauma cases were used as controls. Proximal and distal margin and middle (diseased) sections were stained for calretinin, CD34, and calprotectin. Microscopic images were captured from the mucosa (calretinin), submucosa (calprotectin), and myenteric plexus (CD34), and the immunostaining was quantified using image processing and analysis. Bowel thickness at the corresponding sections were measured and correlated with the amount of immunoexpression. Results: A total of 2, 037 images were analyzed. In stricturing CD, submucosal alteration/thickening at the stricture site correlated with calprotectin staining and inversely correlated with calretinin staining at the proximal margin. Muscularis propria alteration/thickening at the stricture site correlated with mucosal calretinin staining at the proximal margin. Submucosal alteration/thickening at the proximal margin correlated with calretinin and CD34 staining at the proximal margin and inversely correlated with CD34 staining at the stricture site. Calretinin immunostaining at the distal margin was significantly higher in stricturing CD than the controls. Conclusions: Inflammation and tissue remodeling appear to contribute to fibrogenesis in stricturing CD. Increased mucosal calretinin immunostaining distal to the diseased segment could be helpful in diagnosing CD in the right clinical context.
AB - Background: Inflammation and structural remodeling may contribute to fibrogenesis in Crohn's disease (CD). We quantified the immunoexpression of calretinin, CD34, and calprotectin as a surrogate for mucosal innervation, telocytes (interstitial cells playing a role in networking), and inflammation, respectively, and correlated them with bowel alterations in stricturing CD. Methods: Primary resection specimens for ileal CD (n=44, 31 stricturing CD, 13 inflammatory CD) were identified. Left-sided ulcerative colitis and trauma cases were used as controls. Proximal and distal margin and middle (diseased) sections were stained for calretinin, CD34, and calprotectin. Microscopic images were captured from the mucosa (calretinin), submucosa (calprotectin), and myenteric plexus (CD34), and the immunostaining was quantified using image processing and analysis. Bowel thickness at the corresponding sections were measured and correlated with the amount of immunoexpression. Results: A total of 2, 037 images were analyzed. In stricturing CD, submucosal alteration/thickening at the stricture site correlated with calprotectin staining and inversely correlated with calretinin staining at the proximal margin. Muscularis propria alteration/thickening at the stricture site correlated with mucosal calretinin staining at the proximal margin. Submucosal alteration/thickening at the proximal margin correlated with calretinin and CD34 staining at the proximal margin and inversely correlated with CD34 staining at the stricture site. Calretinin immunostaining at the distal margin was significantly higher in stricturing CD than the controls. Conclusions: Inflammation and tissue remodeling appear to contribute to fibrogenesis in stricturing CD. Increased mucosal calretinin immunostaining distal to the diseased segment could be helpful in diagnosing CD in the right clinical context.
KW - Calprotectin
KW - Calretinin
KW - Crohn's disease
KW - Fibrosis
KW - Stricture
KW - Telocyte
UR - http://www.scopus.com/inward/record.url?scp=85139199554&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85139199554&partnerID=8YFLogxK
U2 - 10.4132/JPTM.2022.05.18
DO - 10.4132/JPTM.2022.05.18
M3 - Article
AN - SCOPUS:85139199554
SN - 2383-7837
VL - 56
SP - 239
EP - 248
JO - Journal of Pathology and Translational Medicine
JF - Journal of Pathology and Translational Medicine
IS - 5
ER -