Abstract Background Assessing inflammatory activity in ulcerative colitis (UC) is an essential step in managing treatment. Endoscopic and, beyond that, histological remission are the highest treatment goals for UC. Distinguishing minimal residual activity from histological remission poses a challenge for pathologists. In order to grade histological activity more precisely, the ratio of cryptitis to crypt abscesses is analyzed using digital pathology image analysis software. Methods The digital colonic hematoxylin and eosin (HE) samples from 15 patients with isolated left-sided colitis (endoscopically and histologically confirmed inflammatory regions) were compared with those from endoscopically and histologically non-inflamed areas, as well as with 15 UC patients in clinical, endoscopic, histological, and biochemical remission.These samples were analyzed using digital image analysis software. All crypts and cell types present (including fibroblasts, epithelial cells, lymphocytes, and neutrophil granulocytes) were identified. The presence of neutrophil granulocytes in the crypt margin area defines cryptitis, while their presence in the crypt lumen defines cryptitis. Results The median ratio of cryptitis to healthy crypts in the inflamed regions was 0.0096, and in the non-inflamed was 0.0046 (Figure 1). The median ratio of crypt abscesses to healthy crypts in the inflamed regions was 0.0013 and 0 in non-inflamed remission. Conclusion Our interims analysis indicates that crypts can be adequately evaluated using digital image analysis software. The median ratio of inflamed crypts to healthy crypts differs between inflamed and non-inflamed intestinal samples. Conflict of interest: Dr. Lande, Raul: Raul Lande reports consulting and lecturer fees from AbbVie, Johnson & Johnson, Lilly and Takeda and travel grants from Abbvie Mayer, Robin Sebastian: No conflict of interest Kubesch, Alica: Alica Kubesch reports consulting and lecturer fees from AbbVie, Celgene/BMS, Galapagos, Johnson & Johnson, Takeda and research funding by Sanofi and travel grants from Johnson & Johnson, AbbVie, Takeda, Galapagos and Pfizer. Alica Kubesch was funded by the Bundesministerium für Forschung, Technologie und Raumfahrt (BMFTR, Federal Ministry of Research, Technology and Space) ‒ 01EO2102 INITIALISE Advanced Clinician Scientist Program. Farrag, Karima: Karima Farrag reports consulting and lecturer fees from AbbVie, Amgen, Celgene/BMS, Falk Foundation e.V., Johnson & Johnson, MSD International and Takeda and travel grants from Johnson & Johnson, Pharmacosmos and Lilly. Zeuzem, Stefan: Stefan Zeuzem reports consultancy and speaker’s bureau fees from Abbvie, Allergan, Bi-oMarin, Gilead, Intercept, Johnson & Johnson, MSD/Merck, Novo Nordisk, SoBi and Theratechnologies. Blumenstein, Irina: Irina Blumenstein reports consulting and lecturer fees from Abbvie, Amgen, Biogen, Celgene/BMS, Celltrion, Falk Foundation, Fresenius Kabi, Galapagos, Johnson & Johnson, Lilly, Pharmacosmos, Pfizer, Takeda, scientitic collaboration with Fraunhofer Institute for Translational Medicine and Pharmacology ITMP and Fraunhofer Cluster of Excellence Immune Mediated Diseases CIMD. and travel grants from Pfizer, Johnson & Johnson, Lilly and Takeda. All other authors have no conflict of interest to disclose. Wild, Peter J.: Peter J. Wild reports consulting fees and honoraria for lectures by Bayer, Sanofi, Janssen-Cilag, Novartis, Roche, MSD, Astellas Pharma, Bristol-Myers Squibb, Thermo Fisher Scientific, Molecular Health, Guardant Health, Eli Lilly, Menarini Group, Myriad, Hedera Dx, and Astra Zeneca. Research Support was provided by Astra Zeneca and Roche.
Lande et al. (Thu,) studied this question.