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Endoscopic alterations in Peyer's patches in patients with ulcerative colitis: A prospective, multicenter study
Author(s) -
Hiyama Satoshi,
Iijima Hideki,
Sakakibara Yuko,
Yamada Takuya,
Mukai Akira,
Otake Yuriko,
Yamaguchi Toshio,
Araki Manabu,
Kawai Shoichiro,
Tsujii Yoshiki,
Inoue Takahiro,
Hayashi Yoshito,
Shinzaki Shinichiro,
Takehara Tetsuo
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14933
Subject(s) - medicine , ulcerative colitis , gastroenterology , multicenter study , prospective cohort study , endoscopy , colitis , disease , randomized controlled trial
Background and Aim Peyer's patches (PPs) play a major role in intestinal mucosal immunity; however, their role in ulcerative colitis (UC) is not well investigated. We evaluated endoscopic features of PPs on narrow‐band imaging with magnifying endoscopy (NBI‐ME) and investigated their association with clinical factors. Methods We prospectively recruited 105 patients with UC, 18 with Crohn's disease, 16 with disease control, and 33 healthy control subjects at three institutions from 2014 to 2017. NBI‐ME images of the villi of PPs were evaluated according to the Villi Index, and patients were divided into the Villi Index low (L) and high (H) types. The 1‐year sustained clinical remission rate was evaluated between L‐type and H‐type PPs in patients with UC. Results The proportions of patients with H‐type PPs were significantly higher among UC, Crohn's disease, and disease control patients than among healthy control patients ( P = 0.0125, 0.018, 0.0007). In UC, age, gender, endoscopic score, and extent of disease involvement were not significantly different between L‐type and H‐type PPs, whereas the sustained clinical remission rate was significantly higher in L‐type PPs than in H‐type PPs (88% [57/65] vs 65% [17/26], P = 0.019). Multivariate analysis revealed that the L type of PPs was a significant factor for sustained clinical remission (odds ratio 3.8, 95% confidence interval 1.1–12.9, P = 0.033). Conclusions Patients with UC showed endoscopic alterations in PPs on NBI‐ME, and highly altered appearance of PPs can be associated with a high risk of clinical relapse in patients with UC.