title: Potential utility of a new ulcerative colitis segmental endoscopic index combining disease severity and the extent of inflammation.
abstract: OBJECTIVE
  To investigate the potential utility of a new scoring system, the Ulcerative Colitis Segmental Endoscopic Index (UCSEI), which combines measures of disease severity and extent of inflammation.
  
  
  BACKGROUND
  Intestinal mucosal healing (MH) is a new therapeutic goal for ulcerative colitis (UC). Discontinuous lesions are common in UC and endoscopic observation of the entire colon is important.
  
  
  METHODS
  Patients with active mild-to-moderate UC received daily treatment with oral mesalazine (4 g/d) and mesalazine enemas (1 g/d) for 8 weeks. Endoscopic evaluations, using the UCSEI and Mayo Endoscopic Score (MES), were performed in 5 colonic segments at baseline and week 8. The UCSEI criteria included erythema, vascular pattern, friability, and erosion/ulcer. The sum of 5 subscores, determined for each segment, was calculated as the UCSEI. Disease activity was also assessed using the UC Disease Activity Index (UCDAI). MH was defined as MES=0 to 1.
  
  
  RESULTS
  Of 58 patients, 51 completed the scheduled endoscopic evaluations. At week 8, the UCDAI score had significantly decreased from 6.63 (baseline) to 2.73 (P<0.001). The remission and MH rates were 35.3% and 55.3%, respectively. Segmental endoscopic evaluation, using UCSEI, showed that baseline inflammation tended to be more severe in the distal colon. The baseline UCSEI increased with the extent of disease, which was not seen in MES. Improvements in UCSEI were observed, even in the patients without decreases in the MES.
  
  
  CONCLUSIONS
  UCSEI, reflecting disease severity and extent of inflammation, provides useful information for UC management that is not available with MES.
authors.affiliation: *Sakura Medical Center, Toho University, Sakura †The Jikei University Kashiwa Hospital, Kashiwa ‡Tsudanuma Central General Hospital, Narashino §Tokatsu-Tsujinaka Hospital, Abiko ∥Chiba University Hospital, Chiba ¶Tokyo Dental College, Ichikawa General Hospital, Ichikawa #Secomedic Hospital **Social Insurance Funabashi Central Hospital, Funabashi ††Narita Red Cross Hospital, Narita, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kan
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Masahisa
authors.initials: M
authors.lastname: Kato
authors.forename: Keigo
authors.initials: K
authors.lastname: Matsuo
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kishikawa
authors.forename: Norio
authors.initials: N
authors.lastname: Kimura
authors.forename: Junji
authors.initials: J
authors.lastname: Kasanuki
authors.forename: Soetsu
authors.initials: S
authors.lastname: Ino
mesh_terms: D000284:Administration, Oral; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D003093:Colitis, Ulcerative / Q000145:classification / Q000188:drug therapy / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage; D008875:Middle Aged; D012720:Severity of Illness Index; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine