Localization of TNF alpha in ileocolonic biopsies of patients with inflammatory bowel disease |
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| Affiliation: | 1. Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili and University of Brescia, Italy;2. Gastroenterology Section, 1st Medical Clinic, Spedali Civili and University of Brescia, Italy;3. Gastroenterology Unit, Perugia General Hospital, Italy;4. Pharmacology Section, University of Brescia, Italy;5. Department of Pathology, University of Trieste School of Medicine, Trieste, Italy;6. Department of Surgery, University of Brescia, Italy;7. Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy;1. Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;2. Department of Surgical Oncology, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China;3. Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;4. Department of Urology, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China;5. Department of Pathology, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China;1. Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA;2. Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA;1. Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain;2. Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain;3. Infectious Diseases Service, Hospital Clínic de Barcelona, Barcelona, Spain |
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| Abstract: | BackgroundAlthough antitumor necrosis factor alfa (TNFα) agents are widely used to treat patients with inflammatory bowel diseases (IBD) - both Crohn's disease (CD) and ulcerative colitis (UC) - there is still some uncertainty in the cell type expressing TNFα in human ileo-colonic segments.AimsWe investigated the immunohistochemical (IHC) expression of TNFα in the ileo-colonic segments of patients with both active CD and UC, to establish its anatomic and cellular localization in the inflamed sites. Our aim was to identify patients potentially resistant to anti TNFα agents.Patients and methodsIleo-colonic slides of complete histological mapping of patients with CD and UC before any treatment was started were obtained, and serial sections assessed for TNFα expression, together with IHC markers for lymphocytes, macrophages, and plasma cells.ResultsTNFα was expressed in almost all inflamed segments of IBD patients, albeit with different strength, and was present, in addition to lymphocytes and, to a lesser extent, to macrophages, in plasma cells, where it had a strong positivity, as also demonstrated by colocalization of specific IHC staining. The expression of TNFα was mostly focal in CD patients and more diffuse in UC patients, likely due to the different patterns of inflammation (transmural and mucosal) of the two entities.ConclusionsIn IBD, TNFα is strongly expressed also in plasma cells, and it is easily evidenced by conventional IHC techniques. It remains to be established whether this observation might be useful in future to establish in routine biopsy samples whether patients may be responsive to treatments toward this cytokine. |
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