These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\n
This collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\n
To celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\n
Initially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\n
These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\n
This collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\n
To celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"10677",leadTitle:null,fullTitle:"Advanced Topics of Topology",title:"Advanced Topics of Topology",subtitle:null,reviewType:"peer-reviewed",abstract:"Topology is an area of mathematics that establishes relations and transformations between spaces with a certain structure depending on their position and considering the structure of the ambient space where these relations exist. This book discusses various concepts and theories of topology, including diffeomorphisms, immersions, Hausdorff spaces, cobordisms, homotopy theory, symplectic manifolds, topology of quantum field theory, algebraic varieties, dimension theory, Koszul complexes, continuum theory, and metrizability, among others.",isbn:"978-1-80355-094-7",printIsbn:"978-1-80355-093-0",pdfIsbn:"978-1-80355-095-4",doi:null,price:119,priceEur:129,priceUsd:155,slug:"advanced-topics-of-topology",numberOfPages:136,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"bf964c52f9e653fac20a7fcab58070e5",bookSignature:"Francisco Bulnes",publishedDate:"July 27th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10677.jpg",numberOfDownloads:495,numberOfWosCitations:0,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:null,numberOfDimensionsCitations:1,numberOfDimensionsCitationsByBook:null,hasAltmetrics:0,numberOfTotalCitations:2,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 25th 2021",dateEndSecondStepPublish:"September 14th 2021",dateEndThirdStepPublish:"November 13th 2021",dateEndFourthStepPublish:"February 1st 2022",dateEndFifthStepPublish:"April 2nd 2022",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"92918",title:"Dr.",name:"Francisco",middleName:null,surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes",profilePictureURL:"https://mts.intechopen.com/storage/users/92918/images/system/92918.png",biography:"Dr. Francisco Bulnes, Ph.D., is IINAMEI Director, Mathematics Research Centre, Mexico. He is a member of various international committees of science and serves as a reviewer and editor for British and American journals of mathematics and physics. He is head of the Research Department, GI-TESCHA. He has published more than 100 papers and several books in mathematics and physics. Dr. Bulnes has many theories, theorems, and math objects to his credit. He has received various honors and awards from universities as well as governmental and non-governmental organizations. He received the Doctor Honoris Causa in Education Philosophy and is a Peace Ambassador for ODAEE in Frankfurt, Germany. He is also a distinguished member of the Czech Republic Mathematics Society (JCFM). He obtained two post-doctorates in Mathematics in Cuba and Russia. His research interests include electronics, microelectronics, and spintronics.",institutionString:"Investigación Internacional Avanzada en Matemáticas e Ingeniería (IINAMEI)",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"14",totalChapterViews:"0",totalEditedBooks:"7",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"165",title:"Geometry & Topology",slug:"geometry-and-topology"}],chapters:[{id:"80411",title:"Introductory Chapter: The Topology from Classic Studies until Its Last Frontiers",doi:"10.5772/intechopen.102527",slug:"introductory-chapter-the-topology-from-classic-studies-until-its-last-frontiers",totalDownloads:2,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Francisco Bulnes",downloadPdfUrl:"/chapter/pdf-download/80411",previewPdfUrl:"/chapter/pdf-preview/80411",authors:[{id:"92918",title:"Dr.",name:"Francisco",surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],corrections:null},{id:"78241",title:"More Functions Associated with Neutrosophic gsα*- Closed Sets in Neutrosophic Topological Spaces",doi:"10.5772/intechopen.99464",slug:"more-functions-associated-with-neutrosophic-gs-closed-sets-in-neutrosophic-topological-spaces",totalDownloads:108,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The concept of neutrosophic continuous function was very first introduced by A.A. Salama et al. The main aim of this paper is to introduce a new concept of Neutrosophic continuous function namely Strongly Neutrosophic gsα* - continuous functions, Perfectly Neutrosophic gsα* - continuous functions and Totally Neutrosophic gsα* - continuous functions in Neutrosophic topological spaces. These concepts are derived from strongly generalized neutrosophic continuous function and perfectly generalized neutrosophic continuous function. Several interesting properties and characterizations are derived and compared with already existing neutrosophic functions.",signatures:"P. Anbarasi Rodrigo and S. Maheswari",downloadPdfUrl:"/chapter/pdf-download/78241",previewPdfUrl:"/chapter/pdf-preview/78241",authors:[{id:"426315",title:"Dr.",name:"P. Anbarasi",surname:"Rodrigo",slug:"p.-anbarasi-rodrigo",fullName:"P. Anbarasi Rodrigo"},{id:"426558",title:"Ms.",name:"S.",surname:"Maheswari",slug:"s.-maheswari",fullName:"S. Maheswari"}],corrections:null},{id:"80455",title:"4-Dimensional Canards with Brownian Motion",doi:"10.5772/intechopen.102151",slug:"4-dimensional-canards-with-brownian-motion",totalDownloads:47,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Generally speaking, it is impossible to analyze slow-fast system with Brownian motion. If it becomes possible to do using a new approach, we can evaluate the rigidity of the original system. What kind of the behavior of such a system we have? Using non-standard analysis, on a“hyper finite time line” by Anderson, the Brownian motions are described by step functions. Then, the original differential equations are described by the difference equations due to using non-standard analysis. When constructing the difference equations, the corresponding measure is extended topologically. Because the interval of the difference is according to the hyper finite time line, the topological space is well defined. In this paper, we propose a two-region economic model with Brownian motions. This concrete example gives us new results.",signatures:"Shuya Kanagawa and Kiyoyuki Tchizawa",downloadPdfUrl:"/chapter/pdf-download/80455",previewPdfUrl:"/chapter/pdf-preview/80455",authors:[{id:"427472",title:"Prof.",name:"Shuya",surname:"Kanagawa",slug:"shuya-kanagawa",fullName:"Shuya Kanagawa"},{id:"427473",title:"Dr.",name:"Kiyoyuki",surname:"Tchizawa",slug:"kiyoyuki-tchizawa",fullName:"Kiyoyuki Tchizawa"}],corrections:null},{id:"79299",title:"The Topology of the Configuration Space of a Mathematical Model for Cycloalkenes",doi:"10.5772/intechopen.100723",slug:"the-topology-of-the-configuration-space-of-a-mathematical-model-for-cycloalkenes",totalDownloads:120,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"As a mathematical model for cycloalkenes, we consider equilateral polygons whose interior angles are the same except for those of the both ends of the specified edge. We study the configuration space of such polygons. It is known that for some case, the space is homeomorphic to a sphere. The purpose of this chapter is threefold: First, using the h-cobordism theorem, we prove that the above homeomorphism is in fact a diffeomorphism. Second, we study the best possible condition for the space to be a sphere. At present, only a sphere appears as a topological type of the space. Then our third purpose is to show the case when a closed surface of positive genus appears as a topological type.",signatures:"Yasuhiko Kamiyama",downloadPdfUrl:"/chapter/pdf-download/79299",previewPdfUrl:"/chapter/pdf-preview/79299",authors:[{id:"327075",title:"Prof.",name:"Yasuhiko",surname:"Kamiyama",slug:"yasuhiko-kamiyama",fullName:"Yasuhiko Kamiyama"}],corrections:null},{id:"82378",title:"Covers and Properties of Families of Real Functions",doi:"10.5772/intechopen.100555",slug:"covers-and-properties-of-families-of-real-functions",totalDownloads:9,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"We present results on the relationships of the covering property GΦΨ for Φ,Ψ∈OΛΩΓ and G∈S1SfinUfin of a topological space and the selection property GΦ0Ψ0 of the corresponding family of real functions. The result already published are presented without a proof, however with a citation of the corresponding paper. We present a general Theorem that covers almost all the result of this kind. Some results about hereditary properties are enclosed. We also present Scheepers Diagram of considered covering properties for uncountable covers.",signatures:"Lev Bukovský",downloadPdfUrl:"/chapter/pdf-download/82378",previewPdfUrl:"/chapter/pdf-preview/82378",authors:[{id:"427352",title:"Emeritus Prof.",name:"Lev",surname:"Bukovský",slug:"lev-bukovsky",fullName:"Lev Bukovský"}],corrections:null},{id:"80019",title:"Vertex Decomposability of Path Complexes and Stanley’s Conjectures",doi:"10.5772/intechopen.101083",slug:"vertex-decomposability-of-path-complexes-and-stanley-s-conjectures",totalDownloads:53,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Monomials are the link between commutative algebra and combinatorics. With a simplicial complex Δ, one can associate two square-free monomial ideals: the Stanley-Reisner ideal IΔ whose generators correspond to the non-face of Δ, or the facet ideal I(Δ) that is a generalization of edge ideals of graphs and whose generators correspond to the facets of Δ. The facet ideal of a simplicial complex was first introduced by Faridi in 2002. Let G be a simple graph. The edge ideal I(G) of a graph G was first considered by R. Villarreal in 1990. He studied algebraic properties of I(G) using a combinatorial language of G. In combinatorial commutative algebra, one can attach a monomial ideal to a combinatorial object. Then, algebraic properties of this ideal are studied using combinatorial properties of combinatorial object. One of interesting problems in combinatorial commutative algebra is the Stanley’s conjectures. The Stanley’s conjectures are studied by many researchers. Let R be a Nn-graded ring and M a Zn-graded R-module. Then, Stanley conjectured that depthM≤sdepthM. He also conjectured that each Cohen-Macaulay simplicial complex is partition-able. In this chapter, we study the relation between vertex decomposability of some simplicial complexes and Stanley’s conjectures.",signatures:"Seyed Mohammad Ajdani and Francisco Bulnes",downloadPdfUrl:"/chapter/pdf-download/80019",previewPdfUrl:"/chapter/pdf-preview/80019",authors:[{id:"92918",title:"Dr.",name:"Francisco",surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"},{id:"440971",title:"Dr.",name:"Seyed",surname:"Mohammad Ajdani",slug:"seyed-mohammad-ajdani",fullName:"Seyed Mohammad Ajdani"}],corrections:null},{id:"79892",title:"βI-Compactness, βI*-Hyperconnectedness and βI-Separatedness in Ideal Topological Spaces",doi:"10.5772/intechopen.101524",slug:"-em-em-sub-em-i-em-sub-compactness-em-em-sub-em-i-em-sub-hyperconnectedness-and-em-em-sub-em-i-em-su",totalDownloads:77,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Let XτI be an ideal topological space. A subset A of X is said to be β-open if A⊆clintclA, and it is said to be βI-open if there is a set O∈τ with the property 1 O−A∈I and 2 A−clintclO∈I. The set A is called βI-compact if every cover of A by βI-open sets has a finite sub-cover. The set A is said to be cβI-compact, if every cover Oλ:λ∈Λ of A by β-open sets, Λ has a finite subset Λ0 such that A−∪Oλ:λ∈Λ0∈I. The set A is said to be countably βI-compact if every countable cover of A by βI-open sets has a finite sub-cover. An ideal topological space XτI is said to be βI∗-hyperconnected if X−cl∗A∈I for every non-empty βI-open subset A of X. Two subsets A and B of X is said to be βI-separated if clβIA∩B=∅=A∩clβB. Moreover, A is called a βI-connected set if it can’t be written as a union of two βI-separated subsets. An ideal topological space XτI is called βI-connected space if X is βI-connected. In this article, we give some important properties of βI-open sets, βI-compact spaces, cβI-compact spaces, βI∗-hyperconnected spaces, and βI-connected spaces.",signatures:"Glaisa T. Catalan, Michael P. Baldado Jr and Roberto N. Padua",downloadPdfUrl:"/chapter/pdf-download/79892",previewPdfUrl:"/chapter/pdf-preview/79892",authors:[{id:"425714",title:"Prof.",name:"Michael",surname:"Baldado",slug:"michael-baldado",fullName:"Michael Baldado"},{id:"438024",title:"Dr.",name:"Glaisa",surname:"Catalan",slug:"glaisa-catalan",fullName:"Glaisa Catalan"},{id:"486473",title:"Dr.",name:"Roberto N.",surname:"Padua",slug:"roberto-n.-padua",fullName:"Roberto N. Padua"}],corrections:null},{id:"79797",title:"Clairaut Submersion",doi:"10.5772/intechopen.101427",slug:"clairaut-submersion",totalDownloads:79,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter, we give the detailed study about the Clairaut submersion. The fundamental notations are given. Clairaut submersion is one of the most interesting topics in differential geometry. Depending on the condition on distribution of submersion, we have different classes of submersion such as anti-invariant, semi-invariant submersions etc. We describe the geometric properties of Clairaut anti-invariant submersions and Clairaut semi-invariant submersions whose total space is a Kähler, nearly Kähler manifold. We give condition for Clairaut anti-invariant submersion to be a totally geodesic map and also study Clairaut anti-invariant submersions with totally umbilical fibers. We also give the conditions for the semi-invariant submersions to be Clairaut map and also for Clairaut semi-invariant submersion to be a totally geodesic map. We also give some illustrative example of Clairaut anti-invariant and semi-invariant submersion.",signatures:"Sanjay Kumar Singh and Punam Gupta",downloadPdfUrl:"/chapter/pdf-download/79797",previewPdfUrl:"/chapter/pdf-preview/79797",authors:[{id:"358081",title:"Dr.",name:"Sanjay",surname:"Kumar Singh",slug:"sanjay-kumar-singh",fullName:"Sanjay Kumar Singh"},{id:"426050",title:"Assistant Prof.",name:"Punam",surname:"Gupta",slug:"punam-gupta",fullName:"Punam Gupta"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7428",title:"Advances on Tensor Analysis and their Applications",subtitle:null,isOpenForSubmission:!1,hash:"2339ac5eb978557d01451489e961b102",slug:"advances-on-tensor-analysis-and-their-applications",bookSignature:"Francisco Bulnes",coverURL:"https://cdn.intechopen.com/books/images_new/7428.jpg",editedByType:"Edited by",editors:[{id:"92918",title:"Dr.",name:"Francisco",surname:"Bulnes",slug:"francisco-bulnes",fullName:"Francisco Bulnes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8907",title:"Advances in Quantum Communication and Information",subtitle:null,isOpenForSubmission:!1,hash:"6b074960b5f71319aa57217e7b54216e",slug:"advances-in-quantum-communication-and-information",bookSignature:"Francisco Bulnes, Vasilios N. 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1. Introduction
Asthma is a heterogeneous disease characterized by chronic airway inflammation. The GINA guidelines indicate that inflammation control is a key for management goals and as such is considered a treatment priority. Severe asthma represents a good part of the health spending, with significant impact on patients’ quality of life. Hence, the identification and correct treatment of severe asthma may help to control exacerbations and the inflammatory process, thus improving the personal, social, and economic impact of the disease [1]. In the pathophysiology of asthma, there are multiple processes mediated by various cytokines and cells that cause inflammation. Management goals have been directed toward these molecules and cell targets through the use of corticosteroids, which have meant a dramatic change in the control of the disease. However, these drugs act in a nonspecific way. Furthermore, the development of new monoclonal antibodies could represent a significant milestone for treatment of asthma, reinforcing the essential idea of personalized medicine. In 1984, researchers Jerne, Köhler, and Milstein received the Nobel Prize in Medicine for their work on plasma cell and multiple myeloma cell fusion, which allowed the generation of specific antibodies with the appropriate genetic information, but at high speed. In subsequent years, immunoglobulins synthesized from this new technology, with specific target molecules, such as the endotoxin of Gram-negative bacteria in sepsis, demonstrated an initial benefit. Subsequently, the concept of personalized medicine began to take shape, and in recent years, biomedical research has focused on deepening the molecular mechanisms underlying various pathologies, parallel to the production of new drugs that act at crucial points of specific immunological cascades. Therefore, monoclonal antibodies are an effective and safe therapeutic alternative in many chronic diseases such as rheumatoid arthritis, cancer, and asthma and are seen as a hopeful option in many other diseases. The challenge now is not to get lost in the wide variety of clinical studies that can be found in the literature, as well as in connecting a particular patient with the appropriate management based on the evidence.
2. Critical view of current guidelines and treatment
Large studies on severe asthma have expanded our knowledge about the characteristics of the disease. Severity is defined as the requirement for systemic corticosteroids more than twice a year, the need for at least one hospitalization, previous admission to an intensive care unit, the need for mechanical ventilation in the previous year, impaired pulmonary function determined by a forced expiratory volume in the first second (FEV1) less than 80% of the predicted in the presence of forced vital capacity (FVC) below normal limits after the administration of bronchodilator, or the use of high doses of corticosteroids inhaled and long-acting beta-2-agonists without achieving control of symptoms [2]. In fact, it is estimated that 50% of patients are not well-controlled despite receiving optimal treatment, and that 5–10% do not respond to treatment. Also, receiving high doses of inhaled or systemic corticosteroids increases the risk for adverse effects, which implies an affectation of the additional quality of life due to the sum of other secondary diseases [3]. The GINA guidelines include evidence-based diagnostic and therapeutic recommendation derived from studies that meet all criteria of scientific validity. However, it is possible that in selected patients, guidelines do not accurately reflect what a clinician is trying to address.
The guidelines suggest management according to severity and control, symptom dynamics and pulmonary function, but these are directed to the total population of patients with asthma [1]. In this sense, there will always be a percentage of patients who either receive a suboptimal treatment or who remain unresponsive despite being in the most serious step. Finally, the guidelines are not based on the characteristics of the specific inflammation related to the different phenotypes, which are the ones that could define with greater precision what would be the ideal treatment to stop a specific pathophysiological mechanism [4]. It is not sufficient then to establish a management based only on severity, since there are several aspects that arise from the very concept that asthma is a heterogeneous disease and with different molecular and genetic bases, so if a patient should be typecast within a general parameter, reduce their therapeutic options [5]. On the other hand, the control of severe asthma represents a challenge for specialists in allergology and pneumology due to the high impact of this disease on the quality of life of patients. The GINA guidelines establish levels of disease control according to the response to treatment as follows: well-controlled, partially controlled, and uncontrolled. However, it can differ as patients cataloged in one of the degrees, in reality corresponding to another, taking into account that probably a partially controlled asthma is actually an uncontrolled asthma and that this has therapeutic implications. In daily practice, middle terms cannot be established to define management. Some patients persist without control despite established therapeutic recommendations, which allows us to infer that as with severity, there are other aspects that should be evaluated from the pathophysiology of the disease and not only based on the degree of control of the disease. Additionally, the classification based on control is very strict and poorly documented.
2.1. Approach by phenotypes
It is clear that some characteristics can be identified in some asthmatic patients and not in others; from this arises the concept of “phenotype,” which is defined as the presence of different characteristics that are the product of the interaction of genes with the environment. There may be overlap between them and that the same patient can migrate transiently or definitively from one phenotype to another. The challenge, therefore, is to determine in each patient the individual characteristics.
Several years ago, Chung and Adcock [6] published a review about phenotyping of asthma. The first systematic study of severe asthma carried out in Europe by the group ENFUMOSA (European Network for Understanding Mechanisms of Severe Asthma) [7] consolidated the concept that asthma has a heterogeneous expression, and thus, severe asthma should be considered a different form of the disease, more than simply an increase in the symptoms of it. Subsequent studies included in the Severe Asthma Research Program (SARP) of the United States, together with the results of the ENFUMOSA group, and subsequently of the BIOAIR (Longitudinal Assessment of Clinical Course and BIOmarkers in severe chronic AIRway Disease) [8], have extended the knowledge of clinical expressions and generated new hypotheses about the pathophysiology of severe asthma. In this way, five phenotypes have been established:
Early onset atopic asthma with airway dysfunction, eosinophilic inflammation, and high number of hospitalizations.
Asthma with noneosinophilic inflammation, obesity, and present in the female sex.
Early onset asthma, with few symptoms and minimal eosinophilic inflammation.
Asthma with eosinophilic inflammation, with few symptoms and delayed onset.
Asthma with neutrophilic inflammation.
2.1.1. Severe asthma early onset
It comprises 40% of all severe asthmatics. Patients develop the disease in childhood and have a history of atopy, increased bronchial hyperresponsiveness, higher levels of total immunoglobulin E (IgE), and a higher eosinophil count both peripherally and in sputum, as well as a tendency to subendothelial fibrosis and overexpression of the mucin gene. In general terms, they respond to management with inhaled corticosteroids. Family history suggests a genetic component; in fact, multiple studies have reported associations between genes related to the expression of the Th2 phenotype and multiple polymorphisms related to greater severity. The Th2 pattern of cytokines, including interleukins (IL) 2, 4, 5, 9, and 13, is expressed in the bronchial submucosa of these patients. These cytokines contribute to the allergic inflammation of the airway, generating the activation and the recruitment of B lymphocytes producing specific IgE, mast cells, basophils, and eosinophils. IL-13 also acts as an inducer of the genes of regulator 1 of the chlorine channels, periostin, and the inhibitor of serpin peptidase.
Recently, the role of thymic stromal lymphopoietin (TSLP) has been described as an inducer of IL-4, -5, and -13 production in the initiation of cellular response mediated by Th2 pattern cells, as well as IL-25 and -33, which are produced in response to exposure to allergens, contaminants, and viruses. IL-33, which is a member of the cytokine family of IL-1, possesses potent induction and chemotactic activity of Th2 lymphocytes. Elevated levels of IL-33 and TSLP have been observed in patients with asthma, especially in severe cases [9].
2.1.2. Phenotypes with and without eosinophilia
An increased presence of eosinophils in induced sputum and in peripheral blood can identify the eosinophilic subgroup. The cutoff points are at least 3% of eosinophils in the sputum and peripheral eosinophilia greater than 350 (absolute number). The noneosinophilic phenotype has been defined as asthma with eosinophils in induced sputum less than 3% and increased neutrophilic infiltration. The mechanisms that explain neutrophilia in the airway are not very clear. It has been suggested that this phenotype reflects a “non-Th2” pattern with all its molecular implications. In addition, it is associated with a poor response to treatment with inhaled corticosteroids (even inducing even more neutrophilia), suggesting a Th1 pattern orchestrated by the tumor necrosis factor alpha (TNFɑ), which is assumed to have an important role. Both Th17 cells and bacterial colonization of the airway secondary to defects in phagocytosis have been implicated as causes of neutrophilia [10].
The identification of phenotypes results in a large number of treatments with specific objectives, which have been developed for some years. The challenge is to unify the physiopathology with clinical phenotypes and use that knowledge to discover other phenotypes that have not yet been recognized. None of the clinical phenotypes established to date has a detailed identification of their pathophysiology, biomarkers, genetic elements, stability over time, or the response to a specific treatment. Probably, all the factors that influence a phenotype will need to be incorporated into an endotype, which is nothing else than the subtype defined by the functional or pathophysiological mechanism of the disease for a particular individual.
The support of the evidence regarding the conformation of phenotypes and endotypes continues to be limited by the lack of large-scale longitudinal studies that may intertwine the pathophysiology with the clinical findings. However, there are already phenotypes that seem to be clearly defined in terms of their clinical and molecular bases, and in which the pharmacological intervention with monoclonal antibodies constitutes an important starting point in the management of severe asthma [2].
3. Monoclonal antibodies
Monoclonal antibodies are specialized glycoproteins produced by B cells from a stem cell, forming identical clones of it. They can recognize specific molecules, such as cytokines or receptors.
3.1. Chimeric monoclonal antibodies
They are artificial molecules in which the constant portions of the heavy and light chains come from a human immunoglobulin and the variable regions VL and VH (variable region of the light and heavy chain, respectively) are obtained from an antibody of murine origin. The goal with the construction of a chimeric antibody is to reduce immunogenicity without affecting the selectivity of the antibody for the antigen. These molecules have 66% of human component and 33% of murine origin; they are less immunogenic than the first-generation monoclonal antibodies, but they can still induce an immune response against them. Antibodies of this type end with the prefix ximab (e.g. infliximab, rituximab).
3.2. Humanized antibodies
These molecules have 90% of human origin, so when it is injected into the patients, there is no response from the immune system. Only the antigen binding site (paratope) is of murine origin and is formed from the spatial combination of the hypervariable loops. The rest of the variable region (called M) only works as a scaffold whose function is to serve as structural support to the paratope. In this way, the epitopes associated with the murine M regions, which are present in the chimeric antibodies, are not found in the humanized antibodies. This type of antibody ends with the prefix zumab (e.g., omalizumab, trastuzumab).
3.3. Human antibodies
Almost 100% of its structure is human. However, while the production of mouse monoclonal antibodies is routinely carried out by hybridoma technology, the production of human monoclonal antibodies by this technology has been difficult, because the human hybridomas and cell lines derived from multiple myeloma have been difficult to develop and immunization in vivo is not feasible for many antigens. However, several techniques make it possible to generate human monoclonal antibodies, such as the expression of immunoglobulin fragments, the single-chain variable fractions, and the single strands of the variable fraction. Currently, the development of recombinant monoclonal antibodies by phage library technology with genes that encode the immunoglobulin variable regions has proven useful in basic and clinical research. This type of antibody ends with the prefix mumab or numab (e.g. adalimumab, secukinumab) [11, 12, 13].
The traditional production process of monoclonal antibodies is outlined in Figure 1.
Figure 1.
Types of monoclonal antibodies according to their humanization.
3.4. Development and production
The production of monoclonal antibodies is based on the method of fusion of B lymphocytes from an immunized animal (usually a mouse), with an immortal myeloma cell line and the culture of the cells in a medium in which the nonfused normal and tumoral cells cannot survive. The resulting fused cells that are obtained are called hybridomas and each hybridoma produces only one immunoglobulin, derived from a B lymphocyte of the immunized animal [11]. The method as such consists of the fusion of spleen cells from a mouse immunized to an antigen or mixture of known antigens, with a myeloma cell line, with the subsequent formation of hybrid cells that preserve many chromosomes of the fused pairs. These cells are then placed in a selection medium that allows the survival only of immortalized hybrids, which in turn are cultured as cell clones that secrete the antibody of interest. This method of selection includes hypotaxine, aminopterin, and thymidine, and is therefore called HAT [14]. Antibody-producing hybridomas are expanded in larger capacity culture vessels, and the cells are harvested by centrifugation, suspended in culture medium supplemented with fetal calf serum and dimethyl sulfoxide (DMSO) to freeze, first at −70°C and then in liquid nitrogen. The production of the monoclonal antibody is made from the supernatant of bulk cultures or after intraperitoneal inoculation of the hybridoma in histocompatible animals. In the latter case, an antibody-producing tumor is produced that generates an ascitic fluid rich in these. In both cases, the monoclonal antibodies are separated and purified by conventional methods [15] (Figure 2).
Figure 2.
Schematic process for the production of monoclonal antibodies. Xp: “X” protein.
4. Current and future targets in the management of asthma
4.1. Current targets
4.1.1. Nonspecific blockade of inflammation (corticosteroids and leukotriene antagonists)
At present, asthma control focuses on the use of inhaled corticosteroids, either alone or in association with leukotriene antagonists, and/or long-acting beta-2 agonists. Numerous studies have documented the efficacy of corticosteroids in reducing inflammation, both in children and adults and at any degree of severity. Currently, they are considered the most effective drugs to achieve control in most cases. Its action requires binding to a cytoplasmic receptor (alpha GR), which is associated with heat shock proteins (Hsp90-Hsp60). The binding of the corticoid to its receptor induces the dissociation of these proteins and the translocation of the complex toward the nucleus where several events occur that lead to the activation of the transcription of anti-inflammatory genes and the blocking of those pro-inflammatory. Additionally, corticosteroids interact directly with transcription factors, such as the nuclear factor kB, further blocking the expansion of the inflammatory process.
The use of these drugs has made it possible to reduce both the symptoms and the frequency and severity of the exacerbations, improving quality of life, lung function, and reducing bronchial hyperreactivity. However, their lack of specificity makes them susceptible to generating adverse effects in different organs. In addition, there is a percentage of patients resistant to corticosteroids, a phenomenon explained, among other causes, by the presence of a receptor isoform unable to bind to the glucocorticoid [16].
It is difficult to know if in the medium or long term, corticosteroids will continue to be the standard asthma therapy. Likewise, it is uncertain whether the advent of monoclonal antibodies will allow the reduction of the dose of corticosteroids and/or their total clearance in patients with severe asthma. The cysteinyl leukotrienes comprise C4, D4, and E4 leukotrienes. They are mediators that play an important role in inflammation, mucus secretion, bronchospasm, and remodeling. The antagonists of the type 1 receptors of cysteinyl leukotrienes (montelukast) are potent and selective and block their action in a competitive manner, generating an interruption of the pro-inflammatory intracellular cascade with a subsequent reduction of its effects. Clinical studies show that antagonism of these receptors is beneficial to some degree and percentage of the population. However, it is never superior to the effects achieved with corticosteroids used as monotherapy or in combination with long-acting beta-2 agonists. The precise indications for use in asthma have not been completely defined. It seems that its administration in transient early wheeze triggered by virus and without atopy works to a certain extent [17].
4.1.2. Long-acting β-agonists (LABA) combined
The agonist stimulation of the beta 2 adrenergic receptors generates smooth muscle relaxation of the central and peripheral airways, reversing the bronchial obstruction in asthmatics. The effect is given by the activation of adenylate cyclase (it catalyzes the conversion of adenosine triphosphate—ATP—into cyclic adenosine monophosphate—AMPc), generating the decrease in intracellular calcium, and thus causing muscle relaxation. This treatment always associated with a corticoid is a choice when control is not achieved with the inhaled corticosteroid alone [18].
4.1.3. Anti-IgE therapy
IgE is a clear therapeutic goal in allergic diseases. It is released by the plasmocyte, binds to its receptor of high affinity in the mast cell, and later, upon exposure to the allergen involved, induces several effector responses including the release of mediators responsible of allergic reaction. Omalizumab, a recombinant humanized monoclonal antibody, binds specifically to free serum IgE in its CH3 domain, near the high-affinity receptor binding site, thereby blocking its interaction with mast cells, basophils, antigen-presenting cells, and other inflammatory cells that express the receptor. That binding results in the decrease of free IgE, generating a negative feedback of the receptor of high affinity, and therefore, an interruption of the inflammatory cascade evident by the reduction of the levels of tissue eosinophils and peripheral blood, as well as of the GM-CSF, and IL-2, -4, and -13. They also decrease the presentation of allergens to T cells and the production of cytokines that stimulate differentiation toward the Th2 phenotype [19] (Figure 3).
Figure 3.
Molecular effects of omalizumab. This antibody binds to soluble immunoglobulin E (IgE), preventing its binding to the high-affinity receptor on the mast cell membrane. This generates a negative feedback that induces the internalization of this receptor and the blockade of the entire intracellular inflammatory cascade with the subsequent anti-inflammatory effects. FCƐRI: high-affinity receptor for IgE; Eøs: eosinophils; GM-CSF: colony-stimulating factor of granulocytes and monocytes.
The efficacy and safety of omalizumab treatment in severe asthma has been demonstrated in several controlled studies, showing a significant reduction in exacerbations, a steroid-sparing effect, and improvement in quality of life. The greatest benefit has been observed in patients with allergic asthma, particularly those of greater severity, who failed to respond to conventional treatment [20]. Since 2003, this continues to be its main indication, when it was approved by the Food and Drug Administration (FDA). In 2005, it was approved by the European Medicines Agency (EMA) as an additional therapy in adult patients and in children older than 6 years with persistent severe uncontrolled allergic asthma, with decreased lung function (FEV1 less than 80% of predicted), despite the chronic management with high doses of inhaled corticosteroids plus long-acting beta 2-agonists and with evidence of sensitization to at least one aeroallergen in the skin test or by determination of specific IgE in blood [21]. In Colombia, Invima has approved it since 2005 with the same indication.
4.1.4. Interleukins 4 and 13
IL-4 and -13 are considered the most important cytokines in allergic inflammation in the respiratory tract for a long time; they are essential for the differentiation of CD4+ lymphocytes toward the Th2 phenotype. In addition, they are the promoters of the Ig class switch toward the production of IgE, of the differentiation of the B cells in plasma producing specific Ig E, and of the recruitment of eosinophils to the airway through the receptors for them that are expressed in them. They also stimulate mast cells and other pro-inflammatory cells. IL-13 favors the development of airway fibrosis and mucus hypersecretion, and in conjunction with IL-4, induces inflammation, remodeling, and the proliferation of bronchial fibroblasts and smooth muscle cells [22].
4.1.5. Interleukin 5
It is produced mostly by Th2 cells, mast cells, basophils, and eosinophils. This cytosine mainly conditions the population of eosinophils, from their medullary differentiation to their maturation, survival, and activation. It is a potent inhibitor of eosinophilic apoptosis [23].
4.2. Future targets
4.2.1. Interleukin 9
It is produced by Th2, Th9, basophil, eosinophil, and mast cells, and is thought to be also by neutrophils. This cytokine acts by binding to its IL-9R alpha receptor, generating an increase in the proliferation and attraction of mast cells. It plays a very important role in the differentiation and activation of Th2 cells. Together with interleukins 4 and 13, it acts on the smooth muscle and the airway epithelium, contributing to bronchial hyperreactivity [23].
It is a growth factor involved in the differentiation and survival of eosinophils [23].
4.2.3. Thymic stromal lymphopoietin
It is an epithelial cytokine similar to IL-7, produced in response to a pro-inflammatory stimulus. It acts by inducing the release of cytokines from the Th2 pattern. Patients with asthma have elevated levels of this cytokine in their airway, showing a correlation between the degree of elevation and the severity of the disease. In fact, several studies have shown that some polymorphisms in the locus for the TSLP gene have a protective effect for the development of asthma and bronchial hyperreactivity [24].
4.2.4. Prostaglandin D2 receptor (PTGDR)
It is a receptor located in Th2 cells, innate lymphoid type 2 cells (ILC2), and in eosinophils. Prostaglandin D2 is its natural ligand. PTGDR activation stimulates the synthesis of Th2 cytokines.
4.2.5. Interleukin 25
It is produced by epithelial cells in response to different stimuli. Through the induction of GATA 3, it favors the differentiation toward Th2 and ILC2 cells. It has an essential role in inflammation of the airway and in the remodeling process [25].
4.2.6. Interleukin 33
IL-33 origin and actions are very similar to IL-25. Its effect is even greater and more potent on innate lymphoid cells compared to IL-25. In addition, it activates mast cells and basophils and is a survival factor for eosinophils [26].
4.2.7. Tumoral necrosis factor (TNF-a)
It is produced by epithelial cells, Th1 and Th17 cells. TNF-a promotes the recruitment of eosinophils and neutrophils to the airway by dysregulation of adhesion molecules. It activates macrophages for the production of growth factors and GM-CSF [25].
4.2.8. Intervention in the Th2 pathway with monoclonal antibodies
The possible therapeutic interventions with monoclonal antibodies for the treatment of asthma are outlined in Figure 4. The characteristics of the main molecules and the current evidence available for each of them are detailed in Table 1 [27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45]. Other monoclonal antibodies have fewer studies and possibly have a residual role in the treatment of asthma [46, 47, 48, 49, 50].
Figure 4.
Different monoclonal antibodies with their respective therapeutic targets within the inflammatory cascade of asthma. The neutralization of the different receptors and mediators blocks the intracellular cascade of kinases that amplify the inflammatory process. IL-4Rα: alpha receptor for interleukin 4; IL-13 Rɑ1: alpha 1 chain of the interleukin 13 receptor; rIL-4: inactive recombinant interleukin 4; S-U: subunit.
- Reduction of exacerbations* - Reduction of night awakenings* - Reduction of activities limitation by asthma* - Reduction of exacerbations in patients with eosinophilia - Reduction of need for beta-2’s rescue -FEV1 improvement
- Reduction of bronchial hyperreactivity - Reduction of need for beta-2’s rescue - Improvement of FEV1
- ↓ eosinophilia
300 mg SC/2–4 weeks
Table 1.
Main monoclonal antibodies that have been studied for the treatment of asthma [27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45].
Defects associated with specific polymorphisms. Other monoclonal antibodies that have been studied: anti-TSLP [46]; enokisumab (anti IL-9) [47]; anti-GM-CSF [48]; anti IL-25 [49]; anti IL-33 [50].
rIL-4: inactive recombinant interleukin 4; IL-5Rα: alpha receptor for interleukin 5; IL-5S: soluble interleukin 5; IL-4Rα: alpha receptor for interleukin 4; IL-13: interleukin 13; FEV1: forced expiratory volume in the first second; NS: not significant difference; ACT: asthma control test; ECP: eosinophilic cationic protein; FeNO: expired fraction of nitric oxide; IgE: immunoglobulin E; SC: subcutaneous route; IV: intravenous route.
5. Conclusion(s)
A significant percentage of patients with severe asthma do not achieve control of the disease despite receiving adequate treatment. Current guidelines are outdated and will be even more if biomarkers and specific molecular susceptible of an intervention are not included in future guideline versions.
For now, omalizumab, the only biological treatment available for the management of severe asthma, continues influencing future studies aiming to evaluate new molecules and possible newer targets in selected patients. Linking the characteristics of each patient’s disease, with the effects of a specific monoclonal antibody, will surely imply a much more effective and timely control of the disease.
The detailed approach of the phenotypic characteristics and their molecular basis should lead to a personalized treatment of great precision and effectiveness. A very promising new era in the treatment of asthma is approaching.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"severe asthma, inflammation, phenotype, treatment, monoclonal antibodies",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/60119.pdf",chapterXML:"https://mts.intechopen.com/source/xml/60119.xml",downloadPdfUrl:"/chapter/pdf-download/60119",previewPdfUrl:"/chapter/pdf-preview/60119",totalDownloads:935,totalViews:213,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,introChapter:null,impactScore:0,impactScorePercentile:7,impactScoreQuartile:1,hasAltmetrics:0,dateSubmitted:"October 5th 2017",dateReviewed:"February 14th 2018",datePrePublished:"April 3rd 2018",datePublished:"July 4th 2018",dateFinished:"March 22nd 2018",readingETA:"0",abstract:"Asthma is a multifactorial and complex disease, with different degrees of risks and severity, as well as the response to treatment. Medications currently available are most effective in severe asthma; nonetheless, there is a percentage of patients that have no response to the treatment that guidelines suggest in their recommendations. In the last years, there have been new insights in inflammatory molecules that contribute to asthma physiopathology and a lot of them have been considered to be possible targets in the management of severe asthma. As a consequence of this, a few monoclonal antibodies have been developed evidencing their effectiveness in the treatment of the disease. The study of these new therapies has allowed the identification of specific inflammatory pathways. This chapter intends to offer a critical perspective of the current guidelines for the management of severe asthma, as well as to discuss current treatments and the future on new molecules. Through an adequate characterization, different phenotypes will be recognized and associated with a determinate biomarker and should be used to select the treatment that can offer the highest efficiency in these patients. In this way, the treatment will be directed to a personalized medicine.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/60119",risUrl:"/chapter/ris/60119",book:{id:"6523",slug:"asthma-diagnosis-and-management-approach-based-on-phenotype-and-endotype"},signatures:"Dolly V. Rojas, Diana L. Silva and Carlos D. Serrano",authors:[{id:"224912",title:"Dr.",name:"Carlos",middleName:"D",surname:"Serrano Reyes",fullName:"Carlos Serrano Reyes",slug:"carlos-serrano-reyes",email:"cdserranoreyes@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"224913",title:"Dr.",name:"Dolly",middleName:null,surname:"Rojas Mejía",fullName:"Dolly Rojas Mejía",slug:"dolly-rojas-mejia",email:"Dollyvanessa@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"239946",title:"Dr.",name:"Diana",middleName:null,surname:"Silva",fullName:"Diana Silva",slug:"diana-silva",email:"dianas82@hotmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Critical view of current guidelines and treatment",level:"1"},{id:"sec_2_2",title:"2.1. Approach by phenotypes",level:"2"},{id:"sec_2_3",title:"2.1.1. Severe asthma early onset",level:"3"},{id:"sec_3_3",title:"2.1.2. Phenotypes with and without eosinophilia",level:"3"},{id:"sec_6",title:"3. Monoclonal antibodies",level:"1"},{id:"sec_6_2",title:"3.1. Chimeric monoclonal antibodies",level:"2"},{id:"sec_7_2",title:"3.2. Humanized antibodies",level:"2"},{id:"sec_8_2",title:"3.3. Human antibodies",level:"2"},{id:"sec_9_2",title:"3.4. Development and production",level:"2"},{id:"sec_11",title:"4. Current and future targets in the management of asthma",level:"1"},{id:"sec_11_2",title:"4.1. Current targets",level:"2"},{id:"sec_11_3",title:"4.1.1. Nonspecific blockade of inflammation (corticosteroids and leukotriene antagonists)",level:"3"},{id:"sec_12_3",title:"4.1.2. Long-acting β-agonists (LABA) combined",level:"3"},{id:"sec_13_3",title:"4.1.3. Anti-IgE therapy",level:"3"},{id:"sec_14_3",title:"4.1.4. Interleukins 4 and 13",level:"3"},{id:"sec_15_3",title:"4.1.5. Interleukin 5",level:"3"},{id:"sec_17_2",title:"4.2. Future targets",level:"2"},{id:"sec_17_3",title:"4.2.1. Interleukin 9",level:"3"},{id:"sec_18_3",title:"4.2.2. Granulocyte macrophage colony-stimulating factor",level:"3"},{id:"sec_19_3",title:"4.2.3. Thymic stromal lymphopoietin",level:"3"},{id:"sec_20_3",title:"4.2.4. Prostaglandin D2 receptor (PTGDR)",level:"3"},{id:"sec_21_3",title:"4.2.5. Interleukin 25",level:"3"},{id:"sec_22_3",title:"4.2.6. Interleukin 33",level:"3"},{id:"sec_23_3",title:"4.2.7. Tumoral necrosis factor (TNF-a)",level:"3"},{id:"sec_24_3",title:"Table 1.",level:"3"},{id:"sec_27",title:"5. Conclusion(s)",level:"1"},{id:"sec_31",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Bagnasco D, Ferrando M, Bernardi S, Passalacqua G, Canonica GW. The path to personalized medicine in asthma. Expert Review of Respiratory Medicine. 2016;10:957-965. DOI: 10.1080/17476348.2016.1205490'},{id:"B2",body:'Wensel S. Severe asthma: From characteristics to phenotypes to endotypes. Clinical and Experimental Allergy. 2012;42:650-658. DOI: 10.1111/j.1365-2222.2011.03929.x'},{id:"B3",body:'Dahlen SE. Asthma phenotyping: Noninvasive biomarkers suitable for bedside science are the next step to implement precision medicine. Journal of Internal Medicine. 2016;279:205-207. DOI: 10.1111/joim.12466'},{id:"B4",body:'Boluyt N, Rottier BL, de Jongste JC, Riemsma R, Vrijlandt EJ, Brand PL. Assessment of controversial pediatric asthma management options using GRADE. Pediatrics. 2012;130:658-668. DOI: 10.1542/peds.2011-3559'},{id:"B5",body:'Bel EH. Clinical phenotypes of asthma. Current Opinion in Pulmonary Medicine. 2004;10:44-50. PMID: 14749605'},{id:"B6",body:'Chung F, Adcock I. Asthma: Application of cell and molecular biology techniques to unravel causes and pathophysiological mechanisms. Methods in Molecular Medicine. 2000;44:1-29. DOI: 10.1385/1-59259-072-1:1'},{id:"B7",body:'Abraham B, Anto JME, Barreiro E, Bel EHD, Bonsignore G, Bousquet J, et al. The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. The European Respiratory Journal. 2003;22:470-477. PMID: 14516137'},{id:"B8",body:'Kupczyk M, Dahlén B, Sterk PJ, Nizankowska-Mogilnicka E, Papi A, Bel EH, et al. Stability of phenotypes defined by physiological variables and biomarkers in adults with asthma. Allergy. 2014;69:1198-1204. DOI: 10.1111/all.12445'},{id:"B9",body:'Woodruff PG, Modrek B, Choy DF, Jia G, Abbas AR, Ellwanger A, et al. T helper type 2-driven inflammation defines major subphenotypes of asthma. American Journal of Respiratory and Critical Care Medicine. 2009;180:388-395. DOI: 10.1164/rccm.200903-0392OC'},{id:"B10",body:'Zhang Q, Illing R, Hui CK, Downey K, Carr D, Stearn M, et al. Bacteria in sputum of stable severe asthma and increased airway wall thickness. Respiratory Research. 2012;18: 13-45. DOI: 10.1186/1465-9921-13-35'},{id:"B11",body:'Almagro JC, Fransson J. Humanization of antibodies. Frontiers in Bioscience. 2008;13:1619-1633. PMID: 17981654'},{id:"B12",body:'Ballow M. -ximab this and -zumab that! Has the magic bullet arrived in the new millennium of medicine and science? The Journal of Allergy and Clinical Immunology. 2005;116:738-743. DOI: 10.1016/j.jaci.2005.07.020'},{id:"B13",body:'Reichert JM, Rosensweig CJ, Faden LB, Dewitz MC. Monoclonal antibody successes in the clinic. Nature Biotechnology. 2005;23:1073-1078. DOI: 10.1038/nbt0905-1073'},{id:"B14",body:'Abbas A, Lichtman A. Cellular and Molecular Immunology. 8th ed. Elsevier; 2015. pp. 94-98'},{id:"B15",body:'Yamada T. Therapeutic monoclonal antibodies. The Keio Journal of Medicine. 2011;60:37-46. PMID: 21720199'},{id:"B16",body:'Torrego A, Pujols L, Picado C. Response to glucocorticoid treatment in asthma. The role of alpha and beta isoforms of the glucocorticoid receptor. Archivos de Bronconeumología. 2002;38:436-440. PMID: 12237016'},{id:"B17",body:'Peters-Golden M, Henderson WR. Leukotrienes. The New England Journal of Medicine. 2007;357:1841-1854. DOI: 10.1056/NEJMra071371'},{id:"B18",body:'Barnes PJ. Scientific rationale for inhaled combination therapy with long-acting beta2-agonist and corticosteroids. The European Respiratory Journal. 2002;19:182-191. PMID: 11843317'},{id:"B19",body:'Normansell R, Walker S, Milan SJ, Walters EH, Nair P. Omalizumab for asthma in adults and children. Cochrane Database of Systematic Reviews. 2014;139:28-35. DOI: 10.1002/14651858.CD003559.pub4'},{id:"B20",body:'Kopp MV. Omalizumab: Anti-IgE therapy in allergy. Current Allergy and Asthma Reports. 2011;11:101-106. DOI: 10.1007/s11882-010-0173-4'},{id:"B21",body:'Humbert M, Beasley R, Ayres J, Slavin R, Hebert J, Bousquet J, et al. Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy. 2005;60:309-316. DOI: 10.1111/j.1398-9995.2004.00772.x'},{id:"B22",body:'Wills-Karp M. Interleukin 13 in asthma pathogenesis. Immunological Reviews. 2004;202:175-190. DOI: 10.1111/j.0105-2896.2004.00215.x'},{id:"B23",body:'Sokol CL, Barton GM, Farr AG, Medzhitov R. A mechanism for the initiation of allergen-induced T helper type 2 responses. Nature Immunology. 2008;9:310-318. DOI: 10.1038/ni1558'},{id:"B24",body:'Brusselle GG, Maes T, Bracke KR. Eosinophils in the spotlight: Eosinophilic airway inflammation in nonallergic asthma. Nature Medicine. 2013;19:977-979. DOI: 10.1038/nm.3300'},{id:"B25",body:'Boyman O, Kaegi C, Akdis M, Bavbek S, Bossios A, Chatzipetrou A, et al. EAACI IG Biologicals task force paper on the use of biologic agents in allergic disorders. Allergy. 2015;70:727-754'},{id:"B26",body:'Oboki K, Nakae S, Matsumoto K, Saito H. IL-33 and airway inflammation. Allergy, Asthma & Immunology Research. 2011;3(2):81-88'},{id:"B27",body:'Laviolette M, Gossage DL, Katial R, Leigh R, Olivenstein R, Katial R, et al. Effects of benralizumab on airway eosinophils in asthmatic patients with sputum eosinophilia. The Journal of Allergy and Clinical Immunology. 2013;132:1086-1096. DOI: 10.1016/j.jaci.2013.05.020'},{id:"B28",body:'Busse WW, Katial R, Gossage D, Sari S, Wang B, Kolbeck R, et al. Safety profile, pharmacokinetics, and biologic activity of MEDI-563, an anti-IL-5 receptor alpha antibody, in a phase I study of subjects with mild asthma. The Journal of Allergy and Clinical Immunology. 2010;125:1237-1244. DOI: 10.1016/j.jaci.2010.04.005'},{id:"B29",body:'Bleecker ER, FitzGerald JM, Chanez P, Papi A, Weinstein SF, Barker P, et al. Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): A randomised, multicentre, placebo-controlled phase 3 trial. Lancet. 2016;388:2115-2127. DOI: 10.1016/S0140-6736(16)31324-1'},{id:"B30",body:'FitzGerald JM, Bleecker ER, Nair P, Korn S, Ohta K, Lommatzsch M, et al. Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): A randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2016;388:2128-2141. DOI: 10.1016/S0140-6736(16)31322-8'},{id:"B31",body:'Wang FP, Liu T, Lan Z, Li SY, Mao H. Efficacy and safety of anti-interleukin-5 therapy in patients with asthma: A systematic review and meta-analysis. PLoS One. 2016;11:e0166833.32. DOI: 10.1371/journal.pone.0166833'},{id:"B32",body:'Nair P, Pizzichini MM, Kjarsgaard M, Inman MD, Efthimiadis A, Pizzichini E, et al. Mepolizumab for prednisone dependent asthma with sputum eosinophilia. The New England Journal of Medicine. 2009;360:985-993. DOI: 10.1056/NEJMoa0805435'},{id:"B33",body:'Flood-Page P, Swenson C, Faiferman I, Matthews J, Williams M, Brannick L, et al. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. American Journal of Respiratory and Critical Care Medicine. 2007;176:1062-1071. DOI: 10.1164/rccm.200701-085OC'},{id:"B34",body:'Haldar P, Brightling CE, Hargadon B, Gupta S, Monteiro W, Sousa A, et al. Mepolizumab and exacerbations of refractory eosinophilic asthma. The New England Journal of Medicine. 2009;360:973-984. DOI: 10.1056/NEJMoa0808991'},{id:"B35",body:'Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, et al. Mepolizumab treatment in patients with severe eosinophilic asthma. The New England Journal of Medicine. 2014;371:1198-1207. DOI: 10.1056/NEJMoa1403290'},{id:"B36",body:'Brusselle G, Germinaro M, Weiss S, Zangrilli J. Reslizumab in patients with inadequately controlled late-onset asthma and elevated blood eosinophils. Pulmonary Pharmacology & Therapeutics. 2017;43:39-45. DOI: 10.1016/j.pupt.2017.01.011'},{id:"B37",body:'Li J, Lin C, Du J, Xiao B, Du C, Sun J, et al. The efficacy and safety of reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: A systematic review and meta-analysis. The Journal of Asthma. 2017 Apr;54(3):300-307. DOI: 10.1080/02770903.2016.1212371'},{id:"B38",body:'Wensel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, et al. Dupilumab in persistent asthma with elevated eosinophil levels. The New England Journal of Medicine. 2013;368:2455-2466'},{id:"B39",body:'Wenzel S, Castro M, Corren J, Maspero J, Wang L, Zhang B, et al. Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: A randomized double-blind placebo-controlled pivotal phase 2b dose-ranging trial. Lancet. 2016;388:31-44. DOI: 10.1016/S0140-6736(16)30307-5'},{id:"B40",body:'Wenzel S, Wilbraham D, Fuller R, Getz EB, Longphre M. Effect of an interleukin-4 variant on late phase asthmatic response to allergen challenge in asthmatic patients: Results of two phase 2a studies. Lancet. 2007;370:1422-1431. DOI: 10.1016/S0140-6736(07)61600-6'},{id:"B41",body:'Slager RE, Otulana BA, Hawkins GA, Yen YP, Peters SP, Wenzel SE, et al. IL-4 receptor polymorphisms predict reduction in asthma exacerbations during response to an anti-IL-4 receptor α antagonist. The Journal of Allergy and Clinical Immunology. 2012;130:516-522. DOI: 10.1016/j.jaci.2012.03.030'},{id:"B42",body:'Corren J, Lemanske RF, Hanania NA, Korenblat PE, Parsey MV, Arron JR, et al. Lebrikizumab treatment in adults with asthma. The New England Journal of Medicine. 2011;365:1088-1098. DOI: 10.1056/NEJMoa1106469'},{id:"B43",body:'Hanania NA, Noonan M, Corren J, Korenblat P, Zheng Y, Fischer SK, et al. Lebrikizumab in moderate-to-severe asthma: Pooled data from two randomised placebo-controlled studies. Thorax. 2015;70:748-756. DOI: 10.1136/thoraxjnl-2014-206719'},{id:"B44",body:'Piper E, Brightling C, Niven R, Oh C, Faggioni R, Poon K, et al. A phase II placebo-controlled study of Tralokinumab in moderate-to-severe asthma. The European Respiratory Journal. 2013;41:330-338. DOI: 10.1183/09031936.00223411'},{id:"B45",body:'Brightling CE, Chanez P, Leigh R, O’Byrne PM, Korn S, She D, et al. Efficacy and safety of Tralokinumab in patients with severe uncontrolled asthma: A randomised, double-blind, placebo-controlled, phase 2b trial. The Lancet Respiratory Medicine. 2015;3:692-701. DOI: 10.1016/S2213-2600(15)00197-6'},{id:"B46",body:'Gauvreau GM, O’Byrne PM, Boulet LP, Wang Y, Cockcroft D, Bigler J, et al. Effects of an anti-TSLP antibody on allergen induced asthmatic response. The New England Journal of Medicine. 2014;370:2102-2110. DOI: 10.1056/NEJMoa1402895'},{id:"B47",body:'Parker JM, Oh CK, LaForce C, Miller SD, Pearlman DS, Le C, et al. Safety profile and clinical activity of multiple subcutaneous doses of MEDI-58, a humanized anti-interleukin-9 monoclonal antibody, in two randomized phase 2a studies in subjects with asthma. BMC Pulmonary Medicine. 2011;11:14-23. DOI: 10.1186/1471-2466-11-14'},{id:"B48",body:'Krinner EM, Raum T, Petsch S, Bruckmaier S, Schuster I, Petersen L, et al. A human monoclonal IgG1 potently neutralizing the pro-inflammatory cytokine GM-CSF. Molecular Immunology. 2007;44:916-925. DOI: 10.1016/j.molimm.2006.03.020'},{id:"B49",body:'Ballantyne SJ, Barlow JL, Jolin HE, Nath P, Williams AS, Chung KF, et al. Blocking IL-25 prevents airway hyperresponsiveness in allergic asthma. The Journal of Allergy and Clinical Immunology. 2007;120:1324-1331. DOI: 10.1016/j.jaci.2007.07.051'},{id:"B50",body:'Liu X, Li M, Wu Y, Zhou Y, Zeng L, Huang T, et al. Anti-IL-33 antibody treatment inhibits airway inflammation in a murine model of allergic asthma. Biochemical and Biophysical Research Communications. 2009;386:181-185. DOI: 10.1016/j.bbrc.2009.06.008'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Dolly V. Rojas",address:"dollyvanessa@gmail.com",affiliation:'
Allergy Unit, Fundación Valle del Lili, Faculty of Health Sciences, ICESI University, Cali, Colombia
'},{corresp:null,contributorFullName:"Diana L. Silva",address:null,affiliation:'
Allergy Unit, Fundación Valle del Lili, Faculty of Health Sciences, ICESI University, Cali, Colombia
'},{corresp:null,contributorFullName:"Carlos D. Serrano",address:null,affiliation:'
Allergy Unit, Fundación Valle del Lili, Faculty of Health Sciences, ICESI University, Cali, Colombia
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1. Introduction
Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon characterized by remissions and relapses. The disease almost always begins in the rectum and extends proximally to involve the colon. In some patients, the disease is confined to the rectum (ulcerative proctitis) and in others, the inflammation extends to a variable distance along the colon in a continuous manner. The entire colon is involved in some patients (pancolitis). The clinical presentation and the disease course vary widely amongst patients. Majority of the patients present with an acute episode that clinically mimics any of the acute colitis. The patients on surveillance could show minimal clinical symptoms and minimal histological changes during the periods of remission. Some patients have continuous low activity while some may have an initial episode of active disease followed by long periods of quiescence where the accuracy of the initial diagnosis becomes questionable [1]. Some patients present with the fulminant disease either as the first attack or in an acute exacerbation and this may lead to resection of the colon as an emergency measure.
The pathologist plays a major role in the diagnosis and the management of this chronic relapsing disease. The differing clinical presentations, the chronic relapsing and remitting nature of the disease resulting in recurrent mucosal damage and healing, and the iatrogenic interventions both medical and surgical lead to a variable pathological picture (both macroscopic and microscopic) making the pathologists task a difficult one. Therefore, the diagnosis of UC should always be a combined effort of the clinician, endoscopist, and pathologist. The pathologist should be provided with information regarding clinical symptoms, their duration, the clinical course of the disease, the treatment received by the patient, and the endoscopic appearance of the bowel.
The pathologists are called upon to play various roles during the management of UC. These include the initial diagnosis of the disease and its differentiation from the other forms of colitis and in the classification of inflammatory bowel disease (IBD) in differentiating it from Crohn disease (CD). The morphological differential diagnosis of UC is wide and depends on whether the biopsies are performed during an acute relapse, in remission, or while on treatment.
Assessment of disease activity in UC is another responsibility of the pathologist. There are various clinical and endoscopic activity indices; however, histology is considered to be the gold standard in assessing the disease activity in UC [2]. There are various activity indices used by pathologists. The selection of the activity index that is used in practice is largely determined by the preference of the reporting pathologist and the responsible clinicians [3].
Pathologists are also required to identify dysplasia associated with UC. Dysplasia is an indicator of poor prognosis in UC patients, with a high risk of evolution towards invasive colorectal adenocarcinoma in the absence of treatment. Diagnosis and classification of dysplasia in UC is a challenge to the pathologist and it is a crucial step in the surveillance and management of the patients.
Basic knowledge of the histopathology of this disease is important for clinicians managing UC to interpret and act on the information provided in the pathology report. Here, the morphological features of UC are reviewed, with an emphasis on typical features as well as atypical features that could cause diagnostic pitfalls. The challenges the pathologist faces when examining the diagnostic material at different stages of the disease are highlighted. Further, the use of histological indices for the evaluation of disease activity, identification, and grading of dysplasia associated with UC are also discussed.
2. Macroscopic appearance of ulcerative colitis
UC is characterized by diffuse, continuous inflammation without skip lesions, restricted to the rectal and colonic mucosa. The bowel is characteristically filled with blood-stained dark fluid mixed with mucus. At the onset of the disease, the mucosa shows diffuse granularity, oedema, and erythema justifying the term ‘red velvety’ appearance. With the progression of the disease, the mucosa becomes friable with the appearance of punctate ulcers followed by irregular broad-based ulcers of various sizes. Ulceration may undermine the mucosa creating mucosal bridges. Ulcers distributed along the long axis of the colon extending down to muscularis propria are seen in UC but not the serpentine ulcers that are characteristic of CD. These mucosal changes involve the rectum and variable lengths of the proximal colon in continuity. The distal colon is more severely diseased than the proximal colon. The margin between the inflamed and normal mucosa is distinct and abrupt.
Against a backdrop of mucosal ulceration, there are islands of non-ulcerated residual and regenerating mucosa, bulging into the lumen creating inflammatory pseudopolyps which are usually small, multiple, and bizarre in shape. Sometimes these pseudopolyps could be large and may mimic malignancy (Figure 1) [4].
Figure 1.
Macroscopic appearance of the colon in UC showing involvement of the entire colon with ulceration and pseudopolyp formation.
The mucosa is atrophic and smooth with the absence of mucosal folds in long-standing UC. In the quiescent stage of UC, the mucosa may appear normal or exhibit diffuse granularity and inflammatory pseudopolyps.
The extent of UC is classified according to the Montreal classification as follows [5];
a. Ulcerative proctitis
Only the rectum is affected
b. Left-sided or distal UC
Colonic involvement distal to the splenic flexure
c. Extensive UC or pancolitis
Involvement of the colon extending proximal to the splenic flexure
3. Microscopy appearance of ulcerative colitis
For the optimum assessment of the microscopy, the pathologist should be supplied with adequate and good-quality colonoscopic biopsies. The endoscopist should obtain samples from the ileum, at least four colonic sites, and the rectum, with a minimum of two biopsies from each site [6].
Biopsies from each colonic segment should be submitted in separate containers for each colonic segment, which should be accurately labeled. This is of paramount importance as the pathologist has no means of identifying the separate colonic segments/sites based on histology. This in turn will hinder the pathologists’ attempts at mapping the pattern and distribution of disease activity throughout the colon.
Samples should be fixed immediately by immersion in buffered formalin solution before transport and should be accompanied by clinical information, including endoscopic findings, duration of disease, and current treatment. It is important to sample both endoscopically normal as well as abnormal mucosa as there could be histological activity identified in even endoscopically normal mucosa [7, 8]. Proper orientation of the biopsy during tissue embedding is important as tangentially sectioned biopsies hinder the assessment of the crypt architecture. Serial sectioning is also vital as certain focal features like granulomas may appear at different levels. However, the ideal number of sections is not defined and varies with the laboratory. At least two tissue levels, and preferably three, are advisable [2]. Some laboratories produce step-sections on two slides, but this may incur extra costs. Routine staining with hematoxylin and eosin is appropriate. Special stains and immunohistochemistry are not routinely necessary for the diagnosis or classification of IBD [2].
3.1 Main histological characteristics of ulcerative colitis
The knowledge of the normal histology of the gastrointestinal mucosa is essential for the optimal interpretation of biopsy specimens in IBD. Four main histological characteristics are assessed in the diagnostic process of IBD.
3.1.1 Crypt architectural abnormalities
Normal colonic crypts are straight, parallel, and extend from the surface, up to the muscularis mucosae. The crypt architecture is assessed based on the crypt size, crypt branching, crypt shortening, and variability in inter-crypt spacing. The crypt architectural distortion observed in UC is characterized by irregularly arranged, dilated, branched, fused, and shortened crypts. The crypt size and spacing could vary. This is a manifestation of ongoing inflammation and regeneration [9]. However, the crypts in the anorectal junction and ileocaecal junction can show minor abnormalities resembling architectural distortion due to regional variations. Another point to remember is that the crypt architecture should not be assessed close to lymphoid aggregates as these could result in distortion.
3.1.2 Cellularity in the lamina propria
Lymphocytes and plasma cells are always found in the colorectal lamina propria (LP). Normally, these chronic inflammatory cells are most dense in the upper third of the mucosa and their density decreases towards the base, resulting in the ‘plasma cell gradient’. The absence of the plasma cell gradient is accepted as normal in the caecum and ascending colon. The cellularity in the LP varies depending on the anatomical site of the colon. In general, the caecum and the right colon are most cellular with a progressive decrease in the cellularity from the right to the left side. Dense lymphoid tissue may be found in the normal large bowel, particularly in the rectum. The abundance of eosinophil granulocytes varies a lot between normal individuals and is found to have a seasonal and geographic variation and is more in the right colon and the ileum than the left colon [2, 10].
Abnormal cellularity of the LP refers both to increased and altered distribution of cell types that are normally present. Basal plasmacytosis or plasma cells extending below crypt endings in more than two foci in a biopsy is considered to denote an increase in chronic inflammation (Figure 2).
Figure 2.
Main histological features of UC. (A) Basal plasmacytosis and mucin depletion. (B) Villiform surface, variation in size and shape and branching of crypts. (C) Surface ulceration, diffuse heavy inflammatory cell infiltrate in the lamina propria and crypt abscess formation ((A–C): H&E ×200).
3.1.3 Neutrophil granulocytes in the lamina propria
Normal colonic mucosa does not contain neutrophils except a few scattered neutrophils, that may occur as a result of bowel preparation [11]. Neutrophils are the hallmark of activity in IBD/UC. These are found in the LP or they can infiltrate the crypt surface epithelium (termed cryptitis) or enter the lumen of crypts forming crypt abscesses (Figure 2).
3.1.4 Epithelial abnormalities
These include mucin depletion, surface epithelial damage, and metaplastic changes. Mucin depletion can be defined as a decreased number of goblet cells or decreased amount of intracellular mucin. Focal epithelial cell loss, flattening, erosions, and ulcers denote epithelial damage and reflect the activity of the disease. Metaplastic changes are seen in the form of Paneth cell or pyloric gland metaplasia. None of these findings is disease-specific and might be observed in UC, CD, and other types of colitis.
Working definitions of some of the microscopic features of IBD/UC are given in Table 1 [11].
Microscopic abnormality
Definition
Additional remarks
Crypt distortion
Branching, loss of parallelism, irregularity, tortuosity, dilatation, and variation in shape and size of the crypts
Should not be assessed adjacent to crypt abscesses/lymphoid aggregates/follicles Anal transition zone/columnar cuff unsuitable for assessment
Crypt branching
Two or more branched crypts in a well-oriented biopsy
Branching between mucosal hillocks is normal
Crypt atrophy
Crypt shortening, with an increased gap between crypt base and muscularis mucosae Additional evidence is the wider spacing of crypts; >1 crypt diameter between crypts (normal: 6 crypts/mm in a biopsy with muscularis mucosa)
Caution adjacent to lymphoid aggregates/follicles Anal transition zone/columnar cuff is unsuitable for assessment Mucosal oedema may mimic atrophy
Villiform/irregular mucosal surface
Undulating or broadly villiform surface Wide crypt mouths
Basal plasmacytosis
Plasma cells at the base of mucosa. May separate crypts from muscularis mucosae but not always sub cryptal Loss of plasma cell gradient
Basal plasma cells are normal in the caecum and the ascending colon
Basal lymphoid aggregates
Nodular collections of lymphocytes with or without germinal centres. It may be seen between muscularis mucosae and crypts
One or two transmucosal lymphoid nodules can be seen in normal mucosa; can extend across muscularis mucosae. Pathological aggregate may be difficult to distinguish from normal
Cryptitis
Neutrophils in the crypt epithelium
Crypt abscess
Neutrophils in crypt lumen
Often located near the crypt base
Granuloma
A discrete collection of at least five epithelioid macrophages
Consider crypt rupture as a cause. Serial sections may help
Mucin depletion
Unequivocal reduction of goblet cell mucin in the crypt epithelium
Mucin in normal mucosa may be reduced near lymphoid follicles. Depletion can reflect bowel preparation
Ulceration/erosion
Loss of epithelium replaced by ‘immature’ granulation tissue or the presence of a fibrinopurulent exudate An ulcer extends more deeply than the muscularis mucosae while an erosion does not
It May be difficult to differentiate ulcer and erosion The epithelium can denude artifactually during biopsy procedures or processing
Paneth cell metaplasia
Pyramidal crypt epithelial cells with supranuclear eosinophilic granular cytoplasm
Normal in the caecum and right colon, probably as far as the splenic flexure
Diffuse chronic inflammation
An overall increase in chronic inflammatory cell density throughout the biopsy/biopsies
The caecum and ascending colon may have a higher density of chronic inflammatory cells
Patchy chronic inflammation
Areas of increased chronic inflammatory cell density in a background of variable cellularity
Focal chronic inflammation
Well circumscribed foci of increased chronic inflammatory cell density in a normocellular background
Differentiate from lymphoid aggregates
Focal active inflammation
Focal crypt infiltration by neutrophils in the absence of significant inflammation in the adjacent LP
Uncommon in UC but could be seen in early or treated UC
Table 1.
Working definitions of histological features seen in UC/IBD.
3.2 Typical histological features of ulcerative colitis
The histologic findings in UC vary depending on the clinical phase of the disease and the grade of inflammatory activity. The histological features that define chronicity are crypt architectural distortion, crypt atrophy, diffuse mixed lamina propria inflammation, basal plasmacytosis, basally located lymphoid aggregates, and Paneth cell metaplasia [9]. Inflammatory activity is defined by the presence of neutrophils. Neutrophilic cryptitis, crypt abscesses, hemorrhage, erosions, ulceration, and necrosis are features of active inflammation.
It is convenient to divide the histologic appearances into those seen inactive disease, resolving disease, and disease in remission.
3.2.1 Active ulcerative colitis
The characteristic features of acute UC include architectural distortion which is more in the distal colon than the proximal bowel, diffuse chronic inflammatory cell infiltrates extending up to the muscularis mucosae, and neutrophil infiltration. The neutrophils seem to migrate directly from capillaries into the crypt epithelium (cryptitis) and often form crypt abscesses. Ulcers covered with granulation tissue and regenerative epithelium could be seen. The surface epithelium may take an undulating or low villiform appearance. The inflammation may extend into the superficial submucosa but the muscularis propria and serosa remain free of inflammation, except in fulminant colitis.
Neutrophils are predominant within the lumina of the crypts in UC and comparatively small numbers are seen migrating between the epithelial cells. Crypt abscesses are the precursors of mucosal ulceration and inflammatory polyp formation. In severe active UC, crypt abscesses burst into the loose submucosal tissues and there is a tendency to spread beneath the mucosal membrane, which sloughs off leaving an ulcer. The remaining mucosa is relatively raised from the ulcerated area and forms ‘inflammatory pseudopolyps’.
The inflammatory damage to the crypts produces a variety of degenerative and regenerative changes in the crypt epithelium. There is loss of mucin from goblet cells, often with enlargement and hyperchromatism of nuclei of the absorptive cells. Such changes must not be mistaken for dysplasia. In the presence of attenuated or restituting superficial epithelium, the changes in the crypts are almost certainly reactive [1].
There is a heavy diffuse infiltrate of inflammatory cells in the LP. These include neutrophils, lymphocytes, plasma cells, eosinophils, and mast cells. The presence of deep plasma cells is characteristic of longstanding UC. Many eosinophils may be seen in the LP in some of the biopsies but the role of eosinophils in UC is uncertain and has been subject to many studies [10]. Lymphoid aggregates, that may show germinal centres, are common in UC. These are situated basally between crypt bases and the muscularis mucosae (Figure 3). Epithelioid granulomas, which are a hallmark of CD, are not identified in UC, where only foreign body granulomas evolved as a response to mucin from ruptured crypts (termed cryptolytic granulomas) are observed.
Figure 3.
Histological appearances of active UC. (A) Depletion of mucin in the epithelium, cryptitis, heavy infiltrate of lymphocytes, plasma cells, and eosinophils in the LP (H&E ×400). (B) Marked crypt distortion and crypt abscess formation. (C) Surface ulceration. (D) A lymphoid aggregate with the germinal centre formation in the LP ((B–D): H&E ×200).
3.2.2 Resolving ulcerative colitis
With the resolution of disease, the numbers of inflammatory cells of all types show a variable density, therefore, the LP could be either hyper or hypocellular. Further, the distribution of inflammatory cells becomes uneven. The goblet cell population returns to normal. The crypt architecture will show variable evidence of distortion, depending on the severity of the attack. The crypts may appear short and branched, the changes invariably being more marked distally. The resolution may occur at different rates in different parts of the colon, and this may give rise to the false impression of segmental disease (Figure 4).
Figure 4.
Resolving UC; a mild crypt architectural distortion, normal mucin content in the glands, hypocellular LP, no activity (H&E ×100).
3.2.3 Quiescent ulcerative colitis
Varying degrees of crypt atrophy and distortion are the hallmarks of the quiescent disease. Active inflammation is absent. The muscularis mucosa is thickened and a characteristic finding in UC, especially in rectal biopsies, is the double muscularis mucosae [1]. Paneth cell metaplasia in the left colon and pyloric-type metaplasia in any location of the colon are also features of chronic disease [1].
Although most UC patients have some residual changes of previous damage, such as crypt distortion, atrophy, and Paneth cell metaplasia, it has become increasingly recognized that a group of UC patients may show complete resolution with no evidence of previous disease [12, 13]. This must always raise the question of whether the original diagnosis is UC or infective colitis. In such situations, a careful review of the previous clinical records including the initial biopsies and ancillary investigations may be of help [1].
4. Unusual morphological patterns of ulcerative colitis
There are some exceptions to the classic morphological patterns described above, that may lead to diagnostic confusion. A summary of the unusual morphologic patterns of disease in UC is noted in Table 2. Pathologists need to recognize these patterns to avoid falling into a diagnostic trap.
1. Treatment effect
2. Appendiceal ‘skip’ lesion and ‘caecal patch’
3. Ileal involvement
4. Rectal sparing
5. Paediatric UC-initial presentation
6. Fulminant colitis
Table 2.
Unusual patterns of disease in UC.
4.1 Morphological features of treated ulcerative colitis
Endoscopically or histologically discontinuous disease may be observed in the setting of medically treated UC. This occurs as a result of uneven healing [6]. The same process may also lead to absolute or relative rectal sparing in 30–40% of patients [9]. As patchiness of the disease and rectal sparing mimicking CD is commonly seen in treated UC, evaluation of disease distribution to subtype IBD should not be attempted in this setting. This emphasizes the importance of pre-treatment histology and the value of communication between the clinician and the pathologist.
4.2 Appendiceal ‘skip’ lesions and the ‘caecal patch’ in ulcerative colitis
Appendiceal involvement is demonstrated in about 75% of the total colectomies performed for UC. This may be continuous with extensive colitis or may represent a ‘skip lesion’ of UC with involvement of the more distal colon only [9]. Such a skip lesion may raise the suspicion of CD and be erroneously considered as a contraindication for pouch surgery. The mucosal inflammation in the appendix may extend to the appendiceal orifice and contiguous large bowel as a periappendiceal patch.
Similar to the appendiceal skip lesion, there could be isolated involvement of the caecum and/or ascending colon, which is discontinuous with the left-sided colitis. It is shown that patchy right-sided inflammation in patients with left-sided colitis has little clinical significance but should be recognized by pathologists to prevent a false diagnosis of CD in this setting [14].
It is also interesting that in appendices removed for possible acute appendicitis, inflammation confined to the mucosa with associated crypt distortion should raise the possibility of an appendiceal involvement in UC.
4.3 Involvement of the ileum
Ileitis is found in about 10% of patients with UC, the extent of involvement varying from 50–250 mm [1]. The mucosal changes are similar to those seen in the colon and are always in continuity with the disease in the large bowel. The involvement of the ileum is associated with an open dilated and incompetent ileocaecal valve. Although the term ‘backwash ileitis’ is in common use for this condition, it is not necessarily accurate as evidence for such a mechanism is not yet proven [1]. This condition should not be confused with CD of the terminal ileum which typically shows longer lengths of involvement and is normally associated with chronic active inflammation, and other features of CD. Unfortunately, strict histopathologic criteria for backwash ileitis have not been defined [15].
4.4 Rectal sparing
According to traditional belief, UC is a diffuse continuous disease that begins in the rectum and extends proximally, without skip areas. The term ‘absolute rectal sparing’ refers to the rectum with a normal endoscopic appearance and normal histology. Another term sometimes used is ‘relative rectal sparing’, in which the rectum has inflammation that is less severe than the more proximal colon [16]. Rectal sparing and patchiness of inflammation are seen in medically treated UC, especially with therapeutic steroid enemas. This too emphasizes the importance of the provision of clinical details to the pathologist. The pathologists should also be vigilant not to interpret these findings as definite evidence of CD.
4.5 Ulcerative colitis in pediatric populations
Pediatric-onset of IBD can show fewer characteristic symptoms and histological findings than adult-onset IBD. In general, diagnostic biopsies from children with UC often show less severe inflammation, fewer architectural abnormalities, and less epithelial injury despite extensive disease [2, 6, 17, 18].
The available evidence strongly suggests that UC in children is typically a pancolitis with variable degrees of inflammation on histology [16]. In a subset of pediatric patients, relative rectal sparing and patchy inflammation both endoscopically and histologically may occur at the pre-treatment stage of UC. These features are also observed in treated pediatric patients presumably similar to adults. In a minority, absolute rectal sparing occurs [16]. It is prudent not to preclude the diagnosis of UC in children when these atypical features are present. The precise reason why pre-treatment stage pediatric patients have a higher prevalence of rectal sparing compared to adults is unclear. Younger age (<10 years) at presentation and shorter duration between the symptoms and endoscopy are proposed explanations [19].
4.6 Fulminant ulcerative colitis
Fulminant colitis is defined as severe, acute inflammation of the colon with associated systemic toxicity. Most cases (89%) of fulminant colitis represent IBD, with the remainder relating to ischemia or infection, amongst other aetiologies [20].
In fulminant UC, the inflammatory cell infiltrate extends beyond the mucosa with thinning of the wall. There is separation and oedema of the muscle layer known as myocytolysis. There is diffuse haemorrhagic necrosis of the mucosa, deep fissuring ulcers, and transmural polymorphous inflammation. Unlike in classical UC where the serosa is shiny and intact, there is a purulent or seropurulent exudate seen on the peritoneal surface in many cases of fulminant colitis. The bowel wall is also markedly thinned out and dilated and this usually occurs in the region of the transverse colon. Macroscopic features, such as dilation, skip lesions, rectal sparing, linear ulcers, terminal ileal disease, pseudopolyps, and creeping fat, are poor discriminators of UC and CD, in the setting of fulminant colitis.
5. Histological differential diagnosis of ulcerative colitis and diagnostic pitfalls
5.1 Infective colitis
Infective colitis may clinically mimic acute UC. However, most cases of infectious colitis demonstrate a histological pattern of acute colitis, which may be diffuse, patchy, or focal, without evidence of architectural distortion. Less commonly, chronic infectious colitis may produce a histological pattern of chronic active colitis resembling IBD. Most of these cases have no specific diagnostic features on histological examination and in such cases, knowledge of the clinical history and correlation with serologic studies or stool cultures are required for diagnosis.
Some features help in differentiating acute self-limiting colitis from UC in the acute stage. In acute self-limiting colitis, the neutrophils are plentiful in the LP and are more superficially arranged. In UC, the neutrophils are predominant within the lumina of the crypts and comparatively small numbers are seen migrating between the epithelial cells [1]. Chronic changes, such as crypt distortion in UC, take about 4–6 weeks to develop and this could, therefore, cause a diagnostic difficulty in the early stages of the disease.
In amoebic colitis, presenting as chronic active colitis, there could be trophozoites of Entamoeba histolytica in biopsy material and identifying the trophozoites becomes crucial because, if immunosuppressive therapy is started for presumed IBD in these patients, it can result in perforation due to fulminant amoebic colitis. Superimposed infection with many organisms can occur with established UC and cytomegalovirus (CMV), campylobacter and Clostridium difficile are some of the important secondary infections to be considered when UC presents with an acute exacerbation [21].
5.2 Chronic ischaemic colitis
Chronic ischemia may produce a pattern of chronic active colitis and can present a difficult differential diagnosis. Chronic or recurrent ischemia may cause significant crypt distortion, Paneth cell metaplasia, and chronic active inflammation, all features which mimic UC. However, atrophic and regenerative changes in the epithelium, hyalinization of the LP, and the presence of microthrombi in the adjacent mucosa should suggest ischemia [21]. Overall, in ischemia, the chronic active inflammation is mild relative to the degree of epithelial injury [21]. Further confounding this differential diagnosis, UC has been reported to cause a hypercoagulable state, particularly in genetically predisposed patients. In this setting, a superimposed arterial and venous thrombosis may occur, leading to severe steroid-refractory colitis [21].
5.3 Diverticular disease-associated colitis (DAC)
Chronic active colitis resembling UC may be seen in the setting of diverticulosis. In addition, diverticulosis is a relatively common disease of the elderly and, thus, both diverticulosis and IBD (either CD or UC) may coexist in the same patient. Unlike chronic active colitis of UC, DAC is confined to segments involved by diverticular disease, most commonly the sigmoid colon, and, by definition, spares the rectum. However, UC and diverticular colitis may in some cases represent overlapping entities, as a small subset of diverticular colitis patients has progressed to typical rectosigmoid UC and DAC may respond to medical therapy utilized for IBD [21].
5.4 Drug-induced colitis
Some forms of medication-induced colitis may demonstrate chronic active colitis, which may enter the differential diagnosis of UC. Nonsteroidal anti-inflammatory drugs (NSAIDs) may result in the reactivation of UC. However, in some patients, this group of drugs has also been implicated in initiating UC [1].
The most useful histological feature in distinguishing NSAID-related colitis from UC is an increase in apoptotic bodies in the crypt epithelium and lymphocytes and mononuclear cells of the superficial LP. The morphological changes that occur with NSAIDs include a generalized increase in chronic inflammatory cells in the LP, a prominent eosinophil infiltrate, increased intra-epithelial T lymphocytes and thickening of the subepithelial collagen plate may resemble eosinophilic colitis, lymphocytic colitis, and collagenous colitis, respectively [1].
5.5 Diversion colitis
Diversion colitis develops in segments of the bowel that have been excluded from the fecal stream, such as in a Hartmann’s pouch. This chronic inflammatory condition usually develops within a few months to several years following surgical diversion, and typically regresses completely within 3–6 months of re-establishment of the fecal stream [22]. The disease may mimic IBD on biopsy samples and may show crypt atrophy, distortion, and lymphoid hyperplasia, involving the mucosa and/or submucosa. Symptomatic patients can show superimposed cryptitis, crypt abscesses, and superficial aphthous-type erosions or frank ulceration.
This warrants the importance of obtaining a biopsy of the segment at the time of the surgery to get a baseline analysis and review of the clinical, radiological, and endoscopic information prior to diagnosis.
5.6 Crohn disease (CD)
In most instances, UC and CD may be readily distinguished from each other pathologically, particularly when each exhibits classic histological features assisted by clinical data and other ancillary investigations. There are several circumstances in which the ‘classic’ morphological features that help to distinguish UC from CD are altered or absent. When these atypical morphological features are present, they may mimic CD (Tables 3 and 4). Most of these atypical features have already been discussed in Section 3.
Pathological feature
Ulcerative colitis
Crohn’s disease
Disease distribution
Diffuse and continuous
Segmental
Rectal involvement
Almost always (adults)
Occasionally
Disease severity
Increased distally
Patchy and variable
Ileal involvement
Occasional (‘backwash’)
Often
Inflammation of the colonic wall
Superficial (mucosal)
Transmural
Transmural lymphoid aggregates
Rare, underneath ulcers
Any location
Fissures
Rare superficial in fulminant colitis
Deep, any location
Sinuses and fistulas
Absent
Present
Granulomas
Related to ruptured crypts ‘cryptolytic granuloma’
Not crypt-related and are epithelioid cell granulomas
Table 3.
Classic morphological features helpful in differentiating UC from CD [13].
1.
Discontinuous or patchy disease (‘caecal patch’)
2.
Absolute or relative rectal sparing
3.
Inflammatory changes in the ileum (‘backwash’ ileitis)
4.
Treatment-related change
5.
Granuloma formation
6.
Transmural inflammation
Table 4.
Unusual morphological patterns of UC that may mimic CD.
5.6.1 Granulomas in UC
Approximately 30–40% of CD cases contain either mucosal or mural, non-necrotic granulomas [22]. When present, it is a helpful feature to confidently diagnose CD, especially in mucosal biopsies. Granulomas in CD are composed of loose collections of CD 68 immunostain positive epithelioid histiocytes. When there is rupture of a crypt or extravasated mucin in UC, there could be the formation of a granuloma which is termed a ‘cryptolytic granuloma’ that could be difficult to distinguish from granulomas of CD (Figure 5). Examination of multiple tissue levels that will demonstrate the relationship between granulomas and the crypt epithelium is a helpful measure in this situation. Cryptolytic granulomas often contain an admixture of neutrophils and lymphocytes, in addition to foamy macrophages and multinucleated foreign body-type giant cells and these are not usually seen in CD-related granulomas [22].
Figure 5.
(A) Cryptolytic granuloma following a rupture of a crypt in UC. Extravasated mucin, multinucleated giant cells, and inflammatory cells are seen. (B) Epithelioid cell granuloma formed by histiocytic cells in CD ((A and B) H&E ×400).
5.6.2 Transmural inflammation in UC
In CD, transmural lymphoid aggregates are seen randomly in the wall of the bowel. In fulminant UC when superficial fissuring ulcers that extend into the deep submucosa or superficial muscularis propria are present and in toxic megacolon when myocyte necrosis and serosal inflammation are prominent, there could be mural mononuclear inflammation. However, in contrast to CD, these do not form typical discrete lymphoid aggregates and are usually seen underlying the areas of severe ulceration [22]. Thus, lymphoid aggregates in areas under intact mucosa are not a feature of UC and, in fact, favor a diagnosis of CD.
5.6.3 CD with UC-like features
Typical features of CD such as granulomas, fissuring ulcers, and transmural lymphoid aggregates are seen less commonly in the colon compared to the small intestine [15]. Therefore, some cases of colonic CD may mimic UC by demonstrating only superficial mucosal involvement without inflammatory changes in the submucosa or muscularis propria, diffuse and continuous disease, and even pancolitis. Nearly 20% of CD patients develop colitis without the involvement of the upper GI tract [22]. In these cases, careful evaluation of colonic and ileal biopsies for granulomas, identifying focal or patchy inflammation and activity within the LP, identifying transmural lymphoid aggregates in resections, correlation with a detailed clinical history and imaging will be of help in differentiating UC from CD.
6. Indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU)
In up to 5% of IBD cases, an exact classification of IBD into UC or CD proves difficult due to either the overlapping histological features of the two diseases or to the fact that UC and CD represent two ends of the spectrum of a single disease [1, 6].
Several different terms have been used to refer to this condition, including ‘indeterminate colitis’ (IC), ‘inflammatory bowel disease unclassified’ (IBDU), ‘chronic inflammatory bowel disease unclassified’, and ‘chronic idiopathic inflammatory bowel disease not otherwise specified’. The European Crohn’s and Colitis Organization (ECCO) and the European Society of Pathology (ESP) jointly addressed the ambiguous usage of this terminology, in their consensus report in 2013 [6]. Accordingly, the term IBDU could be used for patients with chronic colitis who have IBD based on the clinical history, but endoscopy and histology of the biopsies show no definitive features of either UC or CD [6]. This term is reserved for biopsy examination as the post-operative examination of resections of such IBDU cases usually provides definitive evidence of UC or CD.
The entity of IBDU is more common in the pediatric population. The possible reasons for this being more colitis than ileitis occurs in CD in early cases and the presence of rectal sparing in UC in the pediatric population [6]. Upper GI biopsies are particularly helpful in these cases.
The pathological diagnosis of IC is made only on resected specimens with the presence of overlapping features or the absence of a clear diagnostic pattern to distinguish CD from UC.
Usually, macroscopically IC shows diffuse disease with involvement of transverse and right colon and less severe inflammation in the distal colon. There is extensive ulceration. Microscopy confirms extensive ulceration with a sharp transition to normal adjacent mucosa and multiple V-shaped ulcers lacking surrounding inflammation. The overlapping histological features of IC are given in Table 5.
Severe mucosal and wall involvement
Non-aggregated transmural inflammation
Fissures reaching the muscularis propria
Discontinuous pattern
Diffuse mucosal disease with normal ileum
Deep mural lymphoid aggregation
Non-necrotizing granulomas in lymph nodes
Anal fistula
Table 5.
Overlapping histological features in indeterminate colitis (IC).
It makes no difference whether the large bowel resection is called ‘UC’ or ‘IC’, but CD needs to be excluded conclusively since an ileal pouch-anal anastomosis (IPAA)/‘pouch’ procedure is generally contradicted in CD.
7. Measuring the disease activity in ulcerative colitis
The complete assessment of disease activity in UC involves symptomatic evaluation, physical examination, measurement of laboratory indices, endoscopic visualization, and the histological assessment of the mucosal inflammation [3]. However, measuring disease activity using all these different parameters is cumbersome and time-consuming in practice and will delay therapy. In routine clinical practice, the disease activity and subsequent medical treatment are usually assessed largely by the clinical symptomatology. Histological assessment of the degree of inflammation is the gold standard for evaluating the true disease activity but its conventional use is limited owing to its inconvenience, invasiveness, and cost [3].
Traditionally, clinical and endoscopic remission were the two main therapeutic targets for UC. However, up to 40% of patients in clinical and endoscopic remission show persistent histological activity [2]. Furthermore, histological activity predicts the worst outcome and histological inflammation represents a significant risk factor for the subsequent development of UC-related colorectal neoplasia. Therefore, histological remission is now increasingly regarded as an important therapeutic target for UC [2].
There are about 30 histological activity indices in IBD, that have been introduced over the last few decades [23]. These systems use different stepwise grading scales for the assessment of inflammation which is used as the basis of grading the disease activity. These scales have four to seven steps and quantitatively assess the following features—architectural changes in the mucosa, chronic inflammatory cell infiltrate, amount and location of neutrophils within the mucosa, crypt abscess formation, erosion, and ulcers.
Of these scores, the ‘Geboes score’ developed in 2000 has been the most widely used and can serve as an independent risk factor for disease progression in UC [24, 25]. The more recent ‘Nancy histological index’ (NHI) and ‘Robarts histopathological index’ (RHI) both from 2016 have proven feasible, easy to use, and are the most extensively validated [26, 27]. There is currently no general agreement on which index should be used. The 2020 ECCO position paper concluded that the NHI can be recommended for daily clinical practice and for clinical trials both the NHI and RHI are feasible [2].
RHI requires assessment of four features which include ulceration/erosion, neutrophils in the epithelium, neutrophils in the LP, and the chronic inflammatory cell infiltrate. Each of the features is subdivided on a scale of 0–3 to calculate the ultimate disease activity score. This may reduce its clinical usefulness and probably is more useful for clinical trials and in research. In NHI, three main histological characteristics which include ulceration, the acute inflammatory cell infiltrate and the chronic inflammatory cell infiltrate are assessed. The NHI is defined by a 5-level classification ranging from grade-0 (absence of significant histological disease activity) to grade-4 (severely active disease) (Table 6) [27].
Histological criteria and defining features
Disease activity
Score
Ulceration Loss of colonic crypts replaced with immature granulation tissue or presence of a fibrinopurulent exudate
Severe
4
Acute inflammatory cells infiltrate Presence of neutrophils in LP and/or epithelial cells
Moderate to severe Presence of multiple clusters of neutrophils in LP and/or in the epithelium that is easily apparent.
3
Mild Few or rare neutrophils in LP or in the epithelium that are difficult to see
2
Absence Assess the chronic inflammatory cell infiltrate
Chronic inflammatory infiltrate Presence of lymphocytes and/or plasma cells and/or eosinophils in LP
Moderate to severe Presence of an increase in chronic inflammatory cell number that is easily apparent
1
Mild No or mild increase in chronic inflammatory cell number
0
Table 6.
Nancy histological index (NHI).
In the NHI, chronic inflammation includes lymphocytes, plasma cells, and eosinophils and it is assessed without quantification. Furthermore, if neutrophilic inflammation is present, regardless of extent, the degree of chronic inflammation is not assessed.
It has been shown that both NHI and RHI have a similar degree of inter and intra-observer agreement and share equivalent feasibility in terms of time taken for scoring the biopsies [28].
Despite the development and validation of novel histologic scoring systems, there are no agreed definitions for histologic healing and remission. Histologic healing is the ultimate goal of the treatment and could be defined as complete normalization of the mucosa [7]. What constitutes complete normalization needs to be precisely defined. Rare architecturally distorted crypts should not be overinterpreted as evidence of persistent architectural abnormalities. A rare, branched crypt can be seen even in a normal colon. Furthermore, the crypts in a normal rectum often do not extend to the muscularis mucosae [7].
The best definition of histologic remission in UC is also unclear. Traditionally, this has been regarded as persistent architectural abnormalities without neutrophilic (active) inflammation, with varying degrees of lymphoplasmacytic inflammation. The presence of mucosal eosinophils is allowed [7]. Ideally, remission includes clinical, endoscopic, and histological resolution, which is called complete remission.
8. Dysplasia and malignancy in ulcerative colitis
The risk of colorectal carcinoma (CRC) is increased in patients with long-term UC compared to the general population. Carcinogenesis in UC is inflammation-driven and has a different pathway than usual colorectal carcinogenesis. Epithelial cells acquire early mutations of TP53 and KRAS genes and no mutations of APC genes, while in non-inflammatory carcinogenesis of the colon, APC mutation is the earliest event [7].
Epithelial dysplasia is the precursor lesion of UC-associated CRC. The features associated with increased risk of dysplasia/CRC in UC include the duration of the disease, the anatomical extent of the disease, early age of onset, concomitant sclerosing cholangitis, family history of CRC, and endoscopic/histological activity of the disease [29]. The prognosis of CRC in IBD may be worse than CRC in the general population and shows higher mortality [9].
8.1 Colorectal dysplasia in ulcerative colitis
The presence of dysplasia in endoscopic biopsies is the most reliable marker of cancer risk. There are no specific clinical features related to dysplasia in UC. Most cases of dysplasia occur in the left/distal colon, and this mirrors the higher incidence of UC-associated colorectal carcinoma (CRC) in the rectosigmoid region. The endoscopic appearance of dysplasia is categorized according to the SCENIC classification and includes visible and invisible lesions. The visible lesions are subdivided into polypoidal (either pedunculated or sessile) and non-polypoidal (superficial, flat, depressed [29].
Dysplasia of the colorectum is defined as an unequivocal epithelial alteration that remains confined within the basement membrane within which it originated. The microscopic features of dysplasia in UC are based on a combination of cytoarchitectural features of the crypt epithelium that remains confined to the mucosa and are identical to those used in the general assessment of dysplasia elsewhere [9]. Dysplasia is classified according to either the Riddell or the Vienna system [30, 31]. In the Riddell system, there are four categories for dysplasia, which are negative, indefinite, low grade, and high grade. The Vienna system has five categories with the addition of invasive carcinoma.
The most common histological subtypes of dysplasia include intestinal (adenomatous) and serrated types [29]. Regardless of these subtypes, dysplasia is divided into low grade and high grade according to the cytoarchitectural features. In low-grade dysplasia (LGD) the crypts may be tubular and/or villous or serrated and they show either no or only mild crypt budding or crowding. The dysplastic cells show enlarged, hyperchromatic nuclei with a high nuclear/cytoplasmic ratio, nuclear stratification limited to the basal half of the cytoplasm, and clumped chromatin or multiple small nucleoli. In serrated dysplasia, the dysplastic cells may show hypereosinophilic, mucin depleted cytoplasm, or a microvesicular epithelium that is similar to the sporadic sessile serrated adenomas. These atypical nuclear features usually involve both the crypt and surface epithelium.
High-grade dysplasia (HGD) exhibits enlarged nuclei with marked nuclear hyperchromasia, pleomorphism, stratification involving the full thickness of the cytoplasm, increased mitoses, and loss of nuclear polarity. It shows complex glandular architecture with crowding, cribriforming, complex branching, and budding [29].
The category indefinite for dysplasia refers to ambiguous epithelial alterations that cannot with certainty be classified either as negative or positive for dysplasia. Some of the settings in which indefinite for dysplasia is considered are shown in Table 7.
1.
Atypical cytological features in an inflammatory background where differentiating regenerative change from LGD/HGD could be difficult
2.
Marked cytological atypia in the crypt bases where surface maturation cannot be assessed due to ulceration or poor orientation
3.
Various artifactual cytological changes occur as a result of poor histological techniques—processing, cutting, staining
4.
Only a very small focus (only a few crypts) shows dysplasia.
Table 7.
Some settings where indefinite for dysplasia are considered.
8.2 Some issues in histopathological reporting in UC-associated dysplasia
Examination of multiple biopsies is necessary to rule out the possibility of dysplasia confidently, as dysplasia is also identified in endoscopically normal mucosa.
The active and resolving phase of UC may cause diagnostic difficulties as the damaged or the regenerative epithelium may harbor mucin depleted cells and atypical nuclear changes, such as enlargement, hyperchromasia, stratification, and brisk mitoses. Careful observation for surface maturation, which is a feature in reactive conditions helps to solve this problem. Another good practice is to perform colonoscopic surveillance during a period of remission of UC.
Inter-observer agreement amongst pathologists for dysplasia associated with UC is suboptimal. Poor reproducibility is seen mainly in indefinite dysplasia and LGD groups. (6). Reporting the biopsies for dysplasia ideally by two histopathologists will help to overcome this problem. A review of the biopsies with the diagnosis of dysplasia by a more experienced gastrointestinal pathologist, before any surgical intervention is undertaken, will optimize the management of these patients.
Adenomas can arise in both affected and non-affected mucosa in UC patients. They are treated like any other adenomas by complete local excision. The stalk or the tissue around the base of the lesion needs to be examined carefully to confirm that these are adenomas or part of a more widespread area of dysplasia associated with UC.
Colonic biopsies of patients treated with immunosuppressive agents, such as cyclosporin for severe UC, are known to show ‘pseudo dysplastic’ changes in the epithelium [32]. Perhaps the most helpful feature is that the ‘pseudo-dysplasia’ induced by cyclosporin is strikingly diffuse, with many, and sometimes all, crypts showing similar changes, a pattern not usually seen in UC associated dysplasia. Therefore, the clinician needs to alert the pathologist to the fact that the patient has been on cyclosporin and that the pathologist in turn should be cautious when diagnosis dysplasia in this situation (Figure 6).
Figure 6.
Dysplasia in UC. (A) Flat low-grade dysplasia with villous configuration. There is no significant pleomorphism or loss of polarity (H&E ×100). (B) High-grade dysplasia with crowding glandular proliferation (H&E ×100). Reprinted by ([21], pp. 178-192). Published by Oxford University press and digestive science publishing Co Limited.
8.3 The demise of the term ‘DALM’ in ulcerative colitis
A diagnosis of dysplasia is made on biopsy material taken from a polyp or a mass evident on endoscopy was historically termed ‘dysplasia associated lesion or mass’ (DALM) and was considered as an indication for colectomy to rule out the possibility of invasive malignancy. In 2015 SCENIC international consensus statement on the surveillance and management of dysplasia in IBD, abandoned the term DALM and replaced it with endoscopically visible and non-visible lesions [33]. With advancements in endoscopic polypectomy and endoscopic mucosal resections (EMR), the concept of DALM is now outdated because most lesions that are noninvasive can be removed using these techniques [1].
8.4 Carcinoma in ulcerative colitis
Carcinomas arising in UC are mostly similar to their counterpart in non-colitis patients except for the background colitis. However, there are some features that are more frequent in UC-associated carcinomas. The tumors could be multiple and often are flat lesions with ill-defined edges, therefore, these tumors are easily felt than seen. Histologically there is a higher incidence of high-grade tumors and mucinous subtypes [1].
9. Conclusions
The pathologist plays a vital role in the diagnosis and follows up of patients with UC. The histological features in the biopsies vary widely depending on the stage of this chronic relapsing and remitting disease, making the differential diagnosis lengthy and challenging. The final diagnosis should be ideally concluded at a clinicopathological meeting. Understanding the typical and atypical histological features of UC is vital in the task of differentiating UC from other types of colitis, mainly CD. Histological disease activity and identifying histological remission are increasingly considered important therapeutic targets. Identifying dysplasia associated with UC and its grading is a crucial step in the surveillance and management of this chronic disease.
Acknowledgments
The authors gratefully thank Dr. D.T.T. Jayasinghe and Dr. R.D.K. Medonza, Postgraduate trainee in Histopathology, Faculty of Medicine, University of Kelaniya, for their assistance in photomicrography.
\n',keywords:"ulcerative colitis, histological features, diagnostic pitfalls, histological disease activity, dysplasia in ulcerative colitis",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/80116.pdf",chapterXML:"https://mts.intechopen.com/source/xml/80116.xml",downloadPdfUrl:"/chapter/pdf-download/80116",previewPdfUrl:"/chapter/pdf-preview/80116",totalDownloads:81,totalViews:0,totalCrossrefCites:0,dateSubmitted:"November 27th 2021",dateReviewed:"December 17th 2021",datePrePublished:"January 19th 2022",datePublished:null,dateFinished:"January 19th 2022",readingETA:"0",abstract:"Pathologists have an essential and wide role in the management of patients with ulcerative colitis (UC) which is a chronic inflammatory disorder of the bowel with remissions and relapses. The initial diagnosis of UC itself is challenging as the histological features vary widely with the clinical phase of the disease. Differentiating UC from other types of acute and chronic colitis, especially Crohn’s disease is crucial in the management. Understanding the characteristic morphological features of UC as well as unusual morphological features of the disease are important in this task. The histological disease activity has now been identified as important in therapeutic decisions. There are several histological activity indices in UC and currently, the Nancy histological index has been recommended to be used in daily clinical practice. Identifying dysplasia associated with UC and its grading is a challenging task for the pathologist and it is a crucial step in the surveillance and management of this chronic disease.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80116",risUrl:"/chapter/ris/80116",signatures:"Gayana Mahendra and Janaki Hewavisenthi",book:{id:"11268",type:"book",title:"Ulcerative Colitis",subtitle:null,fullTitle:"Ulcerative Colitis",slug:null,publishedDate:null,bookSignature:"Dr. Partha Pal",coverURL:"https://cdn.intechopen.com/books/images_new/11268.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-295-8",printIsbn:"978-1-80355-294-1",pdfIsbn:"978-1-80355-296-5",isAvailableForWebshopOrdering:!0,editors:[{id:"345620",title:"Dr.",name:"Partha",middleName:null,surname:"Pal",slug:"partha-pal",fullName:"Partha Pal"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Macroscopic appearance of ulcerative colitis",level:"1"},{id:"sec_3",title:"3. Microscopy appearance of ulcerative colitis",level:"1"},{id:"sec_3_2",title:"3.1 Main histological characteristics of ulcerative colitis",level:"2"},{id:"sec_3_3",title:"3.1.1 Crypt architectural abnormalities",level:"3"},{id:"sec_4_3",title:"3.1.2 Cellularity in the lamina propria",level:"3"},{id:"sec_5_3",title:"3.1.3 Neutrophil granulocytes in the lamina propria",level:"3"},{id:"sec_6_3",title:"Table 1.",level:"3"},{id:"sec_8_2",title:"3.2 Typical histological features of ulcerative colitis",level:"2"},{id:"sec_8_3",title:"3.2.1 Active ulcerative colitis",level:"3"},{id:"sec_9_3",title:"3.2.2 Resolving ulcerative colitis",level:"3"},{id:"sec_10_3",title:"3.2.3 Quiescent ulcerative colitis",level:"3"},{id:"sec_13",title:"4. Unusual morphological patterns of ulcerative colitis",level:"1"},{id:"sec_13_2",title:"4.1 Morphological features of treated ulcerative colitis",level:"2"},{id:"sec_14_2",title:"4.2 Appendiceal ‘skip’ lesions and the ‘caecal patch’ in ulcerative colitis",level:"2"},{id:"sec_15_2",title:"4.3 Involvement of the ileum",level:"2"},{id:"sec_16_2",title:"4.4 Rectal sparing",level:"2"},{id:"sec_17_2",title:"4.5 Ulcerative colitis in pediatric populations",level:"2"},{id:"sec_18_2",title:"4.6 Fulminant ulcerative colitis",level:"2"},{id:"sec_20",title:"5. Histological differential diagnosis of ulcerative colitis and diagnostic pitfalls",level:"1"},{id:"sec_20_2",title:"5.1 Infective colitis",level:"2"},{id:"sec_21_2",title:"5.2 Chronic ischaemic colitis",level:"2"},{id:"sec_22_2",title:"5.3 Diverticular disease-associated colitis (DAC)",level:"2"},{id:"sec_23_2",title:"5.4 Drug-induced colitis",level:"2"},{id:"sec_24_2",title:"5.5 Diversion colitis",level:"2"},{id:"sec_25_2",title:"5.6 Crohn disease (CD)",level:"2"},{id:"sec_25_3",title:"5.6.1 Granulomas in UC",level:"3"},{id:"sec_26_3",title:"5.6.2 Transmural inflammation in UC",level:"3"},{id:"sec_27_3",title:"5.6.3 CD with UC-like features",level:"3"},{id:"sec_30",title:"6. Indeterminate colitis (IC) and inflammatory bowel disease unclassified (IBDU)",level:"1"},{id:"sec_31",title:"7. Measuring the disease activity in ulcerative colitis",level:"1"},{id:"sec_32",title:"8. Dysplasia and malignancy in ulcerative colitis",level:"1"},{id:"sec_32_2",title:"8.1 Colorectal dysplasia in ulcerative colitis",level:"2"},{id:"sec_33_2",title:"8.2 Some issues in histopathological reporting in UC-associated dysplasia",level:"2"},{id:"sec_34_2",title:"8.3 The demise of the term ‘DALM’ in ulcerative colitis",level:"2"},{id:"sec_35_2",title:"8.4 Carcinoma in ulcerative colitis",level:"2"},{id:"sec_37",title:"9. Conclusions",level:"1"},{id:"sec_38",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'Jain D, Warren BF, Riddell RH. Inflammatory disorders of the large intestine. In: Shepherd NA, Warren BF, Williams GT, Greenson JK, Lauwers GY, Novelli MR, editors. Morson and Dawson′s Gastrointestinal Pathology. 5th ed. Chichester, West Sussex, UK: Wiley-Blackwell; 2013. pp. 552-635'},{id:"B2",body:'Magro F, Doherty G, Peyrin-Biroulet L, Svrcek M, Borralho P, Walsh A, et al. ECCO position paper: Harmonization of the approach to ulcerative colitis histopathology. Journal of Crohn’s and Colitis. 2020;14. DOI: 10.1093/ecco-jcc/jjaa110'},{id:"B3",body:'Mahendra BAGG, de S. Hewavisenthi SJ. The role of the pathologist in the assessment of disease activity in ulcerative colitis. Journal of Diagnostic Pathology. 2018;13. DOI: 10.4038/jdp.v13i1.7749'},{id:"B4",body:'Chen W-C, Lashner B, Wang M-H. Giant inflammatory pseudopolyposis mimicking colonic tumor in an ulcerative colitis patient. American Journal of Gastroenterology. 2016;111. DOI: 10.14309/00000434-201610001-01738'},{id:"B5",body:'Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: Controversies, consensus, and implications. Gut. 2006;55:749-753. DOI: 10.1136/gut.2005.082909'},{id:"B6",body:'Magro F, Langner C, Driessen A, Ensari A, Geboes K, Mantzaris GJ, et al. European consensus on the histopathology of inflammatory bowel disease. Journal of Crohn’s and Colitis. 2013;7:827-851. DOI: 10.1016/j.crohns.2013.06.001'},{id:"B7",body:'Pai RK, Jairath V. vande Casteele N, Rieder F, Parker CE, Lauwers GY. The emerging role of histologic disease activity assessment in ulcerative colitis. Gastrointestinal Endoscopy. 2018;88:887-898. DOI: 10.1016/j.gie.2018.08.018'},{id:"B8",body:'Mahendra BAGG. Is endoscopic examination alone adequate in determining the extent of disease in ulcerative colitis? The Srilanka Journal of Surgery. 2006;24:18-21'},{id:"B9",body:'Kellermann L, Riis LB. A close view on histopathological changes in inflammatory bowel disease, a narrative review. Digestive Medicine Research. 2021;4. DOI: 10.21037/dmr-21-1'},{id:"B10",body:'Loktionov A. Eosinophils in the gastrointestinal tract and their role in the pathogenesis of major colorectal disorders. World Journal of Gastroenterology. 2019;25:3503-3526. DOI: 10.3748/wjg.v25.i27.3503'},{id:"B11",body:'Feakins RM. 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Lyon, France: IARC Publications; 2019. pp. 174-176'},{id:"B30",body:'Riddell RH, Goldman H, Ransohoff DF, Appelman HD, Fenoglio CM, Haggitt RC, et al. Dysplasia in inflammatory bowel disease: Standardized classification with provisional clinical applications. Human Pathology. 1983;14:931-969. DOI: 10.1016/S0046-8177(83)80175-0'},{id:"B31",body:'Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, et al. The vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47:251-255. DOI: 10.1136/gut.47.2.251'},{id:"B32",body:'Lichtiger S, Present DH, Kornbluth A, Gelernt I, Bauer J, Galler G, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. New England Journal of Medicine. 1994;330:1841-1845. DOI: 10.1056/nejm199406303302601'},{id:"B33",body:'Laine L, Kaltenbach T, Barkun A, McQuaid KR, Subramanian V, Soetikno R. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. 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\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
\r\n
\r\n\t
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
\r\n
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\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
\r\n
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
\r\n
\r\n\t
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\t
\r\n
\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
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Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Bacterial Infectious Diseases",value:3,count:2},{group:"subseries",caption:"Parasitic Infectious Diseases",value:5,count:4},{group:"subseries",caption:"Viral Infectious Diseases",value:6,count:7}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:229,paginationItems:[{id:"318170",title:"Dr.",name:"Aneesa",middleName:null,surname:"Moolla",slug:"aneesa-moolla",fullName:"Aneesa Moolla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/318170/images/system/318170.png",biography:"Dr. Aneesa Moolla has extensive experience in the diverse fields of health care having previously worked in dental private practice, at the Red Cross Flying Doctors association, and in healthcare corporate settings. She is now a lecturer at the University of Witwatersrand, South Africa, and a principal researcher at the Health Economics and Epidemiology Research Office (HE2RO), South Africa. Dr. Moolla holds a Ph.D. in Psychology with her research being focused on mental health and resilience. In her professional work capacity, her research has further expanded into the fields of early childhood development, mental health, the HIV and TB care cascades, as well as COVID. She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419588",title:"Ph.D.",name:"Sergio",middleName:"Alexandre",surname:"Gehrke",slug:"sergio-gehrke",fullName:"Sergio Gehrke",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038WgMKQA0/Profile_Picture_2022-06-02T11:44:20.jpg",biography:"Dr. Sergio Alexandre Gehrke is a doctorate holder in two fields. The first is a Ph.D. in Cellular and Molecular Biology from the Pontificia Catholic University, Porto Alegre, Brazil, in 2010 and the other is an International Ph.D. in Bioengineering from the Universidad Miguel Hernandez, Elche/Alicante, Spain, obtained in 2020. In 2018, he completed a postdoctoral fellowship in Materials Engineering in the NUCLEMAT of the Pontificia Catholic University, Porto Alegre, Brazil. He is currently the Director of the Postgraduate Program in Implantology of the Bioface/UCAM/PgO (Montevideo, Uruguay), Director of the Cathedra of Biotechnology of the Catholic University of Murcia (Murcia, Spain), an Extraordinary Full Professor of the Catholic University of Murcia (Murcia, Spain) as well as the Director of the private center of research Biotecnos – Technology and Science (Montevideo, Uruguay). Applied biomaterials, cellular and molecular biology, and dental implants are among his research interests. He has published several original papers in renowned journals. In addition, he is also a Collaborating Professor in several Postgraduate programs at different universities all over the world.",institutionString:null,institution:{name:"Universidad Católica San Antonio de Murcia",country:{name:"Spain"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\r\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\r\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Orthodontist, Assoc Prof in the Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"344229",title:"Dr.",name:"Sankeshan",middleName:null,surname:"Padayachee",slug:"sankeshan-padayachee",fullName:"Sankeshan Padayachee",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"315727",title:"Ms.",name:"Kelebogile A.",middleName:null,surname:"Mothupi",slug:"kelebogile-a.-mothupi",fullName:"Kelebogile A. 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Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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