Hundorfean G, Agaimy A, Chiriac MT, Geißdörfer W, Wacker J, Neurath MF, Mudter J. In vivo detection of mucosal healing-involved histiocytes by confocal laser endomicroscopy. World J Gastroenterol 2012; 18(32): 4447-4449 [PMID: 22969212 DOI: 10.3748/wjg.v18.i32.4447]
Corresponding Author of This Article
Gheorghe Hundorfean, MD, Medical ClinicI, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. gheorghe.hundorfean@uk-erlangen.de
Article-Type of This Article
Case Report
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World J Gastroenterol. Aug 28, 2012; 18(32): 4447-4449 Published online Aug 28, 2012. doi: 10.3748/wjg.v18.i32.4447
In vivo detection of mucosal healing-involved histiocytes by confocal laser endomicroscopy
Gheorghe Hundorfean, Abbas Agaimy, Mircea T Chiriac, Walter Geißdörfer, Jochen Wacker, Markus F Neurath, Jonas Mudter
Gheorghe Hundorfean, Mircea T Chiriac, Markus F Neurath, Jonas Mudter, Medical ClinicI, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
Abbas Agaimy, Institute of Pathology, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
Walter Geißdörfer, Microbiology Institute-Clinical Microbiology, Immunology and Hygiene, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
Jochen Wacker, Medical Clinic III, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
Author contributions: Hundorfean G and Agaimy A made equal contribution; Hundorfean G contributes to publication idea, patient selection, endomicroscopy, collection and interpretation of data, manuscript writing, final revision of the article; Agaimy A contributes to histopathology stains, collection and interpretation of data, manuscript writing, final revision of the article; Chiriac MT contributes to collection and interpretation of data, manuscript writing, final revision of the article; Geißdörfer W contributes to polymerase chain reaction-analysis, collection and interpretation of data, manuscript writing, final revision of the article; Wacker J contributes to patient selection, collection and interpretation of data, manuscript writing, final revision of the article; Neurath MF and Mudter J contributes to patient selection, endomicroscopy, collection and interpretation of data, manuscript writing, final revision of the article.
Correspondence to: Gheorghe Hundorfean, MD, Medical ClinicI, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. gheorghe.hundorfean@uk-erlangen.de
Telephone: +49-9131-8545034 Fax: +49-9131-8535102
Received: May 23, 2012 Revised: June 30, 2012 Accepted: August 15, 2012 Published online: August 28, 2012
Abstract
Histiocytes have a pivotal role in wound repair and intestinal epithelial recovery - the most important goal to sustain gut functionality. Yet, an in vivo description of colonic histiocytes by confocal laser endomicroscopy (CLE) is missing. Here, we report the case of a 45-years-old male patient who was referred to our clinic with weight loss and a history of two consecutive Clostridium difficile colitis episodes, the latter cured 3 wk before present admission. Stool microbiology was negative. Conventional colonoscopy showed atrophy and a light mucosal oedema in the distal colon. During on-going endoscopy, we performed a fluorescein-aided CLE which revealed large polygonal (histiocytes-like) cells with copious cytoplasm and large nuclei in the lamina propria of the sigmoid colon as well as regenerative epithelial changes. Histopathological assessment of biopsies from the same areas confirmed the endomicroscopical findings: Periodic acid-Schiff- and CD68-positive foamy histiocytes in the colonic lamina propria and an advanced epithelial recovery. Since stool microbiology was repeatedly negative and polymerase chain reaction-analysis from colonic biopsies could not detect any mRNA for Thropheryma whippleii and common pathogens, we interpreted this particular setting as a mucosal healing process after consecutive Clostridium difficile infections. In conclusion, by describing these colonic histiocytes, we highlight the clinical usefulness of CLE in describing the entity of histiocytes in vivo and in real-time during the process of post-infectious mucosal healing in the colon.
