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P148 Immunohistochemical staining of plasma cells and eosinophils in Inflammatory Bowel Disease: a preliminary report.

G. Canavese*1, V. Villanacci2, R. Rocca3, M. Daperno3, R. Suriani3, M. Salemme2, G. Bassotti4

1Azienda Ospedaliera Città della Salute e della Scienza di Torino, Pathology Department, Torino, Italy, 2Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Pathology Section, Brescia, Italy, 3Ospedale Mauriziano, Gastroenterology Department, Torino, Italy, 4Department of Medicine, University of Perugia School of Medicine, Gastroenterology section, Perugia, Italy

Background

The initial histological diagnosis of inflammatory bowel disease (IBD) is often difficult due to the poorly specific morphological signs of the disease. The early appearance (within 2 weeks) of basal plasmacytosis is the most useful sign in differentiating IBD from non IBD colitis within the first two weeks after symptom onset (1,2,3). Moreover, a recent study demonstrated that the presence of eosinophils intermingled with plasma cells are strictly related to a IBD diagnosis (4). On the other hand, the evaluation of these population of inflammatory elements is often limited by the modification of plasma cell nuclear chromatin, due to tissue processing artifacts or to incorrect staining. Purpose of the study was to evaluate the advantages of immunohistochemical (IHC) staining of eosinophils and plasma cells in colonic biopsies in order to improve the detection of basal plasmacytosis.

Methods

44 cases of naïve patients (first diagnosis, no ongoing treatment), 20 cases with histological diagnosis of IBD and 24 cases with non IBD colitis, with complete mapping of ileocolic segments were recruited for the study. Biopsy samples from each site of the endoscopic mappings were stained with a monoclonal antibody against plasma cells (CD138, clone MI15 - Dako, Denmark 1:700) and against eosinophil granulocytes ( CD193 Abcam 1:100)

Results

IHC double staining with the two antibodies demonstrated a basal distribution of plasma cells intermingled with eosinophil granulocytes in 20/20 (100%) of cases of IBD colitis and in 7 out of 24 (29%) cases of non IBD colitis (p < 0.05).

Conclusion

(1) IHC stains allows an easy detection of basal plasmacytosis in all cases of IBD colitis and in a smaller proportion of non IBD cases. The technique demonstrated high sensibility and lower specifity in this preliminary study. (2) the detection of inflammatory cell populations by IHC markers could provide new insights on the value of basal plasmacytosis in the diagnostic process.

(3) more reliable data about the distribution of the above mentioned cells during the natural history of the disease and in non-IBD colitis could open new perspectives in understanding the pathogenesis of the disease and in surveillance and treatment strategies.

References:

[1] Schumacher G, Kollberg B, Sandstedt B. , (1994), A prospective studyof first attacks of inflammatory bowel disease and infectious colitis., Scand J Gastroenterol 1994; 29: 318-32.

[2] Jenkins D, Balsitis M, Gallivan S, Dixon MF, Gilmour HM, Shepherd NA, Theodossi A, Williams GT, (1997), Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative, J Clin Pathol 1997; 50: 93-105.

[3] Geboes K, (2001), Pathology of inflammatory bowel diseases (IBD): variability with time and treatment, Colorectal Dis. 2001 Jan;3(1):2-12.

[4] Villanacci V, Antonelli E, Reboldi G, Salemme M, Casella G, Bassotti G, (2014), Endoscopic biopsy samples of naïve "colitides" patients: Role of basal plasmacytosis, J Crohns Colitis. 2014 Jun 12. pii: S1873-9946(14)00175-5. doi: 10.1016/j.crohns.2014.05.003