John Gásdal Karstensen, MD, from the Gastro Unit, Division of Endoscopy, Copenhagen University Hospital Herlev, in Copenhagen, Denmark, describes his article “Confocal laser endomicroscopy in ulcerative colitis: a longitudinal study of endomicroscopic changes and response to medical therapy (with videos).”

The focus of this study was to correlate endomicroscopic mucosal features with disease activity and histopathology in ulcerative colitis (UC). Further, we examined how endomicroscopic findings change after intensified medical treatment and correlated these with changes in endoscopic and histopathological scores.

The majority of studies with confocal laser endomicroscopy (CLE) has been conducted with endoscope-based CLE. We wanted to test whether the promising results in patients with UC could be reproduced with probe-based CLE and how the findings correlated with endoscopic and histopathological scores. The study was longitudinal, which in addition enabled us to correlate endomicroscopic changes over time with corresponding endoscopic and histopathological changes.

In UC patients with clinical relapse, an augmented crypt architecture and colonic fluorescein leakage were significantly correlated to the severity of the disease (Table 3). After intensified medical treatment, a significant correlation was found between histopathological progress and improvement of abnormal colonic crypt architecture, but we did not observe a resolution of the intestinal barrier dysfunction without fluorescein leakage. The latter may reflect that few patients reached complete endoscopic remission, and we hypothesize that a restored barrier function represents the deepest state of mucosal remission.

Find the article abstract here.

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