Thickness and continuity of the adherent colonic mucus barrier in active and quiescent ulcerative colitis and Crohn's disease
Thickness and continuity of the adherent colonic mucus barrier in active and quiescent ulcerative colitis and Crohn's disease
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DOI：
10.1111/j.1742-1241.2007.01665.x
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发表时间：
2008-05-01
影响因子：
2.6
通讯作者：
Pearson, J. P.
中科院分区：
文献类型：
--
作者：
Strugala, V.;Dettmar, P. W.;Pearson, J. P.
背景：结肠被一层粘液屏障所覆盖，该粘液屏障保护底层粘膜，这种粘液屏障的改变与炎症性肠病（IBD）的病因有关。本研究调查了溃疡性结肠炎（UC）和克罗恩病（CD）患者黏液屏障的厚度和连续性，并与正常对照进行了比较。方法：对59例患者进行直肠活检，冰冻切片采用周期性酸-希夫蓝/阿利新蓝染色，可见黏液层。光镜下测定黏液厚度、连续性及杯状细胞密度。结果：正常人直肠黏液层基本连续，静止性UC的黏液屏障无变化。在活动性UC中，黏液层有逐渐变薄的趋势，随着疾病严重程度的增加，黏液层明显变得更加不连续。在严重的活动性UC中，黏液层厚度和杯状细胞密度与正常对照相比显著降低，而不连续性的百分比显著增加。结论：直到严重UC时，由于大面积缺乏粘液，杯状细胞损失导致分泌潜力下降，即使存在更薄、更不有效的黏液层，粘膜保护才会发生全局变化。
Background: The colon is covered by a mucus barrier that protects the underlying mucosa and alterations in this mucus barrier have been implicated in the aetiology of inflammatory bowel disease (IBD). This study investigated the thickness and continuity of the mucus barrier in ulcerative colitis (UC) and Crohn's disease (CD) in comparison to normal controls. Methods: Rectal biopsies were taken from 59 patients and cryostat sections stained with periodic acid-Schiff's/Alcian blue to visualise the mucus layer. Mucus thickness and continuity and goblet cell density were measured using light microscopy. Results: An essentially continuous adherent mucus layer was observed in normal human rectum and there was no change in the mucus barrier in quiescent UC. In active UC there was a trend for the mucus layer to become progressively thinner and significantly more discontinuous as disease severity increased. In severe active UC the mucus layer thickness and goblet cell density were significantly reduced compared with normal controls while the percentage discontinuity significantly increased. Conclusion: It is not until severe UC that there is a global change in mucosal protection as a consequence of large regions lacking mucus, a decrease in secretory potential caused by a loss of goblet cells and a thinner, less effective mucus layer even when it is present.