title: Histological inflammation in ulcerative colitis in deep remission under treatment with infliximab.
abstract: OBJECTIVE
  There are few data on how histological signs of inflammation develop under treatment with infliximab (IFX). We investigated the patterns of histological features of inflammation in patients with UC in sustained clinical and endoscopic remission under IFX.
  
  
  METHODS
  We performed a retrospective study on 47 patients with UC in clinical and endoscopic remission and undergoing surveillance colonoscopy with biopsies while receiving maintenance therapy with IFX. Each colonic segment was evaluated based on the Mayo endoscopic subscore and the Geboes histology score (range 0-5.4).
  
  
  RESULTS
  Globally, 6110 biopsy specimens were collected from 235 colonoscopies. At the beginning of the follow-up, histological features of inflammation were found in 48.9% of patients receiving maintenance IFX therapy; 25.9% of them had at least moderate inflammation based on histology scores. At the end of the follow-up, when patients were still under endoscopic and clinical remission, 40.4% of patients had at least one biopsy specimen with evidence of any histological inflammation during the follow-up, and 19.1% had biopsy specimens that met the Geboes criteria for histological inflammation and architectural alteration. In none of the different disease locations (pancolitis, left-sided colitis, distal colitis) histological inflammation improved significantly during the follow-up.
  
  
  CONCLUSIONS
  Patients in clinical and endoscopic remission from UC under IFX still frequently have histological features of inflammation.
authors.affiliation: Gastroenterology Service, ASL BAT, Via Torino, 49, 76123 Andria (BT), Italy. Electronic address: antotursi@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tursi
authors.affiliation: Division of Gastroenterology, ASL RMH, Albano Laziale, Roma, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Elisei
authors.affiliation: Division of Surgery, "P.-Colombo" Hospital, ASL RMH, Velletri, Roma, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.affiliation: Digestive Endoscopy Unit, "S.-Maria Goretti" Hospital, Latina, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Forti
authors.affiliation: Division of Gastroenterology, "S.-Paolo" Hospital, Bari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Penna
authors.affiliation: Department of Pathology, "Lorenzo Bonomo" Hospital, Andria (BT), Italy.
authors.forename: Cosimo Damiano
authors.initials: CD
authors.lastname: Inchingolo
authors.affiliation: Department of Pathology, "Lorenzo Bonomo" Hospital, Andria (BT), Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Nenna
authors.affiliation: Division of Gastroenterology, "Cristo Re" Hospital, Roma, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brandimarte
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000139:chemically induced; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000069285:Infliximab