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FOXP3 + regulatory T ‐cell counts correlate with histological response in C rohn's colitis treated with infliximab
Author(s) -
Sloan Samuel,
Maxwell Perry,
SaltoTellez Manuel,
Loughrey Maurice B.
Publication year - 2014
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12219
Subject(s) - infliximab , foxp3 , medicine , inflammatory bowel disease , tumor necrosis factor alpha , colitis , cd68 , immunohistochemistry , monoclonal antibody , biopsy , inflammation , gastroenterology , t cell , immunology , pathology , antibody , disease , immune system
C rohn's disease is a chronic inflammatory bowel disease of unknown aetiology. Mucosal inflammatory dysregulation is likely important, with increased production of pro‐inflammatory cytokines, including tumour necrosis factor alpha ( TNF α). The chimeric monoclonal antibody, infliximab, inhibits TNF α and promotes intestinal mucosal healing. Despite this, many patients still require surgical intervention. Patients who have undergone colonic resection post‐infliximab therapy, show markedly variable morphological response to treatment. FOXP3 + CD4 + regulatory T ‐cells have been shown to have a protective role in autoimmune/inflammatory diseases and their sequestration to the bowel is found in those treated with infliximab. We examined the immunohistochemical profile of lymphoid aggregates in tissue sections from post‐infliximab C rohn's colitis resection specimens, classified as morphological responders or non‐responders, defined in relation to the absence/presence of mucosal ulceration and active inflammation, and a control group. Results indicated no significant diffences in CD68 ‐positive cell counts but increased FOXP3 ‐positive ( P = 0.02) and CD4 ‐positive ( P = 0.05) cell counts in responders versus non‐responders. Untreated control scores were similar to non‐responders. Although based on small study numbers, our results suggest an association between upregulation of FOXP3 +/ CD4 + regulatory T ‐cells and morphological response to infliximab therapy. This represents a possible quantitative methodology for monitoring therapeutic response to infliximab therapy, based on immunohistochemical evaluation of endoscopic biopsy specimens.