Pathologist Prof. Thaddeus Stappenbeck (Washington School of Medicine at St Louis, Missouri, USA) and his team examined healthy regions of intestinal tissues from patients with CD to identify defects that might contribute to pathogenesis and chronicity of inflammatory bowel diseases [1]. Performing RNA sequencing from formalin-fixed paraffin-embedded ileal tissue sections of 36 patients with CD and 32 individuals without CD, the researchers catalogued the expression changes between inflamed and uninflamed tissues from the same patient. The researchers then developed methods to visualise an overlapping modular network of genes dysregulated in the samples and validated their findings using biopsy samples from the UNITI-2 phase 3 trial of ustekinumab for patients with CD and healthy individuals.
Using cluster analyses, the researchers found a cluster of genes encoding proteins associated with the enterocyte brush border to be significantly downregulated, leading them to investigate microvilli. A separate set of samples (3 control and 4 CD samples) was analysed by transmission electron microscopy (see Figure), in which they validated in all CD samples that the microvilli were shorter and less organised than in the control samples. The expression of microvilli genes correlated with microvilli length and endoscopy score and was also associated with response to treatment with ustekinumab. This research warrants follow-up to evaluate causality vs effect.
Figure. Electron micrograph of microvilli. Left panel, healthy control patient, right panel, microvilli from a CD patient [1]
1. Stappenbeck T et al. UEG Week 2019, Abstract LBA03.
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Table of Contents: UEGW 2019
Featured articles
Interview with UEG President Prof. Paul Fockens
Upper GI Disorders
Locally active corticosteroid promising in eosinophilic oesophagitis
First-in-human radiofrequency vapor ablation in Barrett’s oesophagus
Irritable Bowel Syndrome
Faecal microbiota transplantation is effective for irritable bowel syndrome
Human milk oligosaccharides improve IBS symptoms
Inflammatory Bowel Disease
Ustekinumab is safe and effective in ulcerative colitis: 2-year data
Decreased microvilli length in CD patients
Phase 2 data shows benefit for mirikizumab in CD patients
Subcutaneous ustekinumab as maintenance therapy in UC
First evidence of long-term efficacy of ABX464 in ulcerative colitis
New treatment may reverse coeliac disease
IBD prevalence 3 times higher than estimated and expected to rise
Microbiome and Microbiota
Early stages of gastric metaplasia: molecular profiling
Plant-based foods and Mediterranean diet associated with healthy gut microbiome
Antibiotic resistance in H. pylori has doubled over last 20 years
Pancreatitis
New model predicts recurrence of acute biliary pancreatitis
Hepatology
Restrictive strategy for cholecystectomy selection does not reduce pain, but does reduce surgery
β-blockers may halt cirrhosis progression: PREDESCI trial
Obeticholic acid prevents liver fibrosis from NASH
Oncology
Metal stents are better than plastic for endoscopic biliary drainage
Ramosetron relieves low anterior resection syndrome
Immunonutrition during neoadjuvant oesophagogastric cancer therapy: no benefit
Endoscopy
EUS-guided histological specimens from the pancreatic cyst wall
Digital single-operator cholangioscopy more sensitive than endoscopic retrograde cholangiopancreatography
New single-use duodenoscope well-liked by endoscopists
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