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Flow cytometric analysis of lymphocytes isolated from endoscopic biopsies in ulcerative colitis

Objective In inflammatory bowel disease, surgical specimens are unsuitable for the study of the course of disease and the influence of therapy on lamina propria lymphocytes. The possibility of using per-endoscopic rectal biopsies to overcome this drawback was evaluated in this study. Design Lymphocytes, identified by flow cytometry, were isolated from rectal biopsies taken during routine endoscopy from patients with ulcerative colitis and from subjects with no signs of acute or chronic bowel inflammation. The resulting data were compared with those from the literature, which were generally derived from total colectomy specimens. The influence of therapy on lamina propria lymphocyte subset distribution was evaluated. Results The concentration of lamina propria lymphocytes changed significantly in patients with active ulcerative colitis only when compared with controls. The concentrations of CD3+ and CD19+ cells increased despite concurrent 5-aminosalicylic acid or steroid treatment. Activated B (CD3-/HLA-DR+) and T helper (CD4+) cell levels were higher in patients treated with 5-aminosalicylic acid than in all the other groups studied. Activated T lymphocyte (CD3+/HLA-DR+) and T suppressor (CD8+) cell levels were higher in patients with active ulcerative colitis taking steroids than in those with active disease on 5-aminosalicylic acid. Conclusions This study shows that endoscopic biopsies could be used to study local immunological aspects and to monitor the response to different treatments in ulcerative colitis.