Disease activity and mucosal healing in inflammatory bowel disease: a new role for histopathology?
Histologic evaluation of disease activity in the setting of inflammatory bowel disease is gaining interest within the gastroenterology community. Recent data suggests that histologic measurements of inflammation in ulcerative colitis are more sensitive at detecting disease activity and perform better than endoscopic measurements in predicting clinical outcomes. Histologic measurements are also increasingly used in ulcerative colitis clinical trials to assess response to new therapies. Histologic measurements of disease activity are less well studied in Crohn’s disease, but are gaining attention. Current published treatment algorithms in inflammatory bowel disease do not take into consideration histologic activity; however, this may change in the near future. In order for histologic measurements to be included in clinical decision-making, validated, reliable, and responsive histologic scoring systems are needed. In this review, the recent literature on the significance of histologic activity in both ulcerative colitis and Crohn’s disease is summarized. Histologic scoring systems are also briefly discussed.
KeywordsInflammatory bowel disease Ulcerative colitis Crohn's disease Mucosal healing
Compliance with ethical standards
The authors have complied with all ethical standards as outlined on the Virchows Archives website.
Conflict of interest
Rish K. Pai has received consulting income in the past 12 months from Robarts Clinical Trials (a non-commercial entity). Karel Geboes reports no conflicts of interest.
The authors have received no funding for this work.
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