Conductance scanning pinpoints colon "leaks" in ulcerative colitis

NEW YORK (Reuters Health) – Use of an electrophysiological imaging systems allows detection of epithelial barrier defects in colon specimens, an approach which might eventually be of use in treatment of inflammatory bowel disease, according to German researchers.

Dr. Alfred H. Gitter and colleagues from the Freie Universitat, Berlin, report in the December issue of Gastroenterology that they compared results from conductance scanning of specimens from colonic surgery with those of conventional histological examination of the same tissues.

Sigmoid colon samples studied included noninflamed controls as well as inflamed material obtained from patients with ulcerative colitis who had undergone colectomy.

Overall conductivity in specimens with mild ulcerative colitis, and thus an intact epithelium, was 35% higher than in controls and in moderate-to-severe inflammation it was 300% higher.

Moreover the spatial distribution of conductance was even in controls, but showed "dramatic leaks" in the ulcerative colitis specimens. Leaks in specimens with mild inflammation and no epithelial lesion were the foci of epithelial apoptosis. In moderate-to-severe inflammation, they correlated with epithelial erosion or ulcer-type lesions or with crypt abscesses.

Local leaks were responsible for 19% of overall epithelial conductivity in mild inflammation, and 65% in moderate-to-severe inflammation.

Commenting on the findings, Dr. Gitter told Reuters Health that this technique "allowed [doctors], for the first time, to locate and quantify functional defects in the epithelial barrier of the inflamed colon. In the future, if the method can be adapted for in vivo application…topical treatment of early stages of inflammatory bowel disease may become feasible."

Gastroenterology 2001;121:1320-1328.

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