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PubMed1992

[Radiologic assessment of extent of ulcerative colitis in acute phase].

One of the major reference points for both prognosis and treatment of ulcerative colitis is the assessment of its extent. Plain abdominal radiographs were performed on 97 patients previously diagnosed, by means of rectoscopy and histobiopsy, as having acute ulcerative colitis. Within the following 36 hours they underwent either full colonoscopy or colectomy. The extent of colitis was evaluated by means of double-blind radiography. The results were then statistically compared with those obtained from endoscopy or from direct study of surgical colonic specimens. There was agreement between the final X-ray results and the actual extent of ulcerative colitis in 78 of 97 patients (80.4%, r = 0.86). The highest agreement was observed in those patients whose lesions were localized in the rectosigma (81%) and in those with fully extended colitis (90%). The most useful radiological findings in predicting the extent of colic lesions were irregular mucosal profile and thickening of colic wall. The presence of these two signs, together with the flattening or swelling of interhaustral folds and the impossible visualization of the right colon, are invariably suggestive of fully extended colitis. On the contrary, no abnormal findings were present on plain abdominal films in 74% of proctosigmoiditis cases. Plain abdominal radiography seems to be useful for the initial evaluation of acute ulcerative colitis. It allows the early discrimination between diffuse and localized forms, and makes it possible to postpone more invasive and dangerous investigations to a remissive phase of the disease.

Acute Disease↗
PubMed2004

[Prophylactic effect of Lactobacillus GG in animal colitis and its effect on cytokine secretion and mucin gene expressions].

BACKGROUND/AIMS: Lactobacillus rhamnosus GG (LGG) has been used in acute colitis treatment. However, it is unclear whether the LGG prevents chronic colitis. The aim of this study was to examine the prophylactic effect of LGG on animal colitis, cytokine secretion, and mucin gene expression. METHODS: BALB/c mice (n=64) were exposed to 5% dextran sulfate sodium (DSS) for 7 days followed by 10 days recovery period and repeatedly exposed for 4 days. Then, the mice were devided into three group; group of oral LGG adminstration throughout the recovery and repeated colitis period; PBS group of PBS administration; control group. Colon length, histologic score, tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10) levels, mucin gene expressions were determined at each period. RESULTS: In acute colitis period, the LGG group showed higher levels of disease activity index (DAI), histologic score, TNF-alpha, IL-10, but shorter colon length, lower levels of mucin gene expressions than the control group. However, in repeated colitis period, the LGG group showed markedly lower levels of DAI and IL-10 but significantly longer colon length than PBS group (p<0.05). There was no difference in the mucin gene expression. CONCLUSIONS: These results suggest that LGG prevents chronic murine colitis. It may be associated with cytokine modulation and competitive inhibition of pathogenic bacteria. However, it may not be related with gene expression.

Animals↗
PubMed2004

Dual role of endogenous nitric oxide in development of dextran sodium sulfate-induced colitis in rats.

The role of nitric oxide (NO) in the etiology of ulcerative colitis is controversial with reports of the improvement and aggravation of colonic lesions by inducible NO synthase (iNOS) inhibitors. In the present study, we compared the effect of the selective iNOS inhibitor aminoguanidine and the nonselective NOS inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME) on a dextran sulfate sodium (DSS)-induced model of colitis in rats. Experimental colitis was induced by a 3% DSS-solution added to drinking water for 7 days. Aminoguanidine (5 approximately 20 mg/kg) and L-NAME (10 mg/kg) were administered p.o. twice daily for the first 3 days, the last 3 days or all 6 days of DSS treatment. Body weight and severity of colitis (diarrhea, bloody feces) were observed over a period of 7 days. DSS treatment resulted in severe colonic lesions, accompanied by diarrhea, bloody feces, decrease of body weight and colon shortening. All of the parameters investigated improved significantly with aminoguanidine treatment at 20 mg/kg for 6 days or the last 3 days of DSS-treatment, but L-NAME did not significantly affect the colitis during these periods. When L-NAME or aminoguanidine was given in the first 3 days of DSS treatment, the colonic lesions were slightly aggravated by L-NAME but not affected by aminoguanidine. The expression of iNOS mRNA was observed from the 3(rd) day of DSS treatment. These results suggested that endogenous NO exerts a biphasic influence on DSS-induced colitis, depending on the NOS isoenzyme; a beneficial effect of NO derived from constitutive NOS and a detrimental effect of NO produced by iNOS in the development of colitis.

Animals↗
PubMed2005

[Microscopic colitis].

A 38-year old woman is admitted in the gastroenterology unit for a disabling episode of watery diarrhoea, not bloody and refractory to anti-diarrheic drugs. Different diagnostic exams remain negatives, with the exception of colic biopsies who disclose a lymphocytic colitis, one of the forms of the microscopic colitis entity. Microscopic colitis is an anatomo-clinic syndrome characterized by the presence of histological abnormalities on colic biopsies amongst patients suffering from chronic watery diarrhoea without endoscopic anomalies. Two clinical entities are today well known: collagenous colitis is characterized by a thickening of the sub-epithelial collagen band of the colon; lymphocytic colitis is defined as an increased level of lymphocytic cells, more than 20%, in the epithelial surface of colorectal mucosa. Inflammatory lesions of the chorion and alterations of the epithelial surface are seen in the two types of colitis. Their etiology remains unknown. It could be due to inflammatory lesions from autoimmune origin, activated by various exogenous agents such as bacteria and drugs. Clinical (feminine prevalence, frequent association with auto-immune diseases) and morphological similarities lead to argue and to hypothesis that both entities could represent different stages of the same disease, the lymphocytic colitis being the early stage. Various treatments have been proposed, for instance 5-aminosalicylates, but today mainly synthetic corticoids are used, especially budesonide. Others entities are recently been described: the chronic pericrypt eosinophilic enterocolitis and the colonic epithelial lymphocytosis ("epidemic").

Adult↗
PubMed2006

Differential expression in histologically normal crypts of ulcerative colitis suggests primary crypt disorder.

Ulcerative colitis is characterized by crypt infiltration particularly of neutrophils. However, it is not known whether it reflects a primary crypt disorder or a secondary inflammatory response. In this study, we analyzed the expression profiles of histologically normal crypts microdissected from formalin-fixed biopsies of early stage ulcerative colitis. Total RNAs were extracted, amplified, and applied to Affymetrix GeneChip(R) X3P Array. For the control, similar crypts from nonspecific colitis biopsies were applied. A total of 353 (4.3%) and 111 (1.4%) genes were >3 times up-, and down-regulated in ulcerative colitis. Up-regulated genes included FCGBP (Fc fragment of IgG binding protein), cyclophilin A, chemokine (C-X-C motif) ligand 3, and genes associated with lipid metabolism. Down-regulated genes included APOA4 (apolipoprotein A-IV), cylindromatosis, BCL2-like 10, claudin 8, and numerous transcriptional regulators. FCGBP and APOA4 have been implicated in ulcerative colitis previously. Our data show differential expression in the crypt epithelia of ulcerative colitis before active inflammation is initiated, suggesting primary crypt abnormalities that might be implicated in the pathogenesis of ulcerative colitis.

Adult↗
PubMed1990

Rectal cell proliferation and colon cancer risk in ulcerative colitis.

Cell proliferation kinetics of 30 patients affected by extensive ulcerative colitis in remission have been studied with autoradiography of rectal biopsies incubated with tritiated thymidine. The results have been compared with those of 20 control subjects without evidence of colonic diseases, and of 16 patients with multiple nonfamilial colonic adenomas. The labeling index was similar in the three groups (P = NS). On the contrary, the labeling frequency (SEM) in the upper 40% of the crypt (phi h value) was 0.04 +/- 0.01 in controls, 0.16 +/- 0.02 in ulcerative colitis, and 0.10 +/- 0.01 in adenoma patients (P less than 0.001 ulcerative colitis versus controls, P less than 0.01 adenomas versus controls, P = NS ulcerative colitis versus adenomas). The distribution of phi h values in ulcerative colitis showed a bimodal trend with 22 patients having mean phi h values similar to adenoma patients (0.10 +/- 0.01) and 8 with higher values (0.30 +/- 0.02). No relationship was found between phi h values and duration of colitis, age of patients, or age at onset of symptoms. These data show that cell kinetics studies can detect patients at particularly high risk of colon cancer, and that additional factors should determine colon cancer risk level in ulcerative colitis.

Adenoma↗
PubMed1989

Studies in longstanding ulcerative colitis with special reference to malignant transformation of the colorectal mucosa.

The risk of colorectal carcinoma was estimated retrospectively in a cohort of patients with ulcerative colitis from three defined geographical areas (West Midlands and Oxford regions, England and Stockholm County, Sweden). The cohort consisted of 824 primary referral patients with a diagnosis of ulcerative colitis established within five years from onset of symptoms between 1945-1965. All patients were 15 years of age or more at onset and they were followed for a minimum of 17 years and a maximum of 38 years. There was an eight-fold risk of developing colorectal cancer in the series as a whole, relative to that of the general population. In extensive colitis the risk was nineteen-fold. The cumulative risk of developing cancer in extensive colitis was 12% after 25 years of disease duration. No significant effects of the cancer risk for age at onset, sex or referral centre were detected. Abnormal, aneuploid DNA-content of cell nuclei in colorectal mucosal biopsies was found in five out of 53 patients with longstanding, total ulcerative colitis in a prospective study using flow cytometric DNA-analyses. Findings of DNA-aneuploidy were found at repeated examinations in four of these patients and there was a correlation with precancerous, mucosal changes (dysplasia) found at histological examination. In one patient DNA-aneuploidy preceded the finding of a carcinoma (Dukes' A) in the colon. Microspectrophotometry of imprint preparations from mucosal biopsies was compared to flow cytometry for detection of nuclear DNA-aneuploidy in seven patients with ulcerative colitis in a prospective study. DNA-aneuploidy was detected in five patients in eight separate locations of the colon and rectum. There was a good conformity between the two methods in the detection of DNA-aneuploidy, which was detected in non-dysplastic mucosa as well as in association with dysplasia. In a fifteen year follow-up surveillance program, comprising 72 patients with total ulcerative colitis, colonoscopy was performed at fixed intervals and biopsies sampled from ten predetermined locations in the colon and rectum. Definite dysplasia developed in 12 patients, two of which had carcinoma (Dukes' A). Nine patients were selected for prophylactic colectomy due to findings of dysplasia. A sequential development of dysplasia was found in seven patients. The cumulative risk of developing at least low grade dysplasia was 14% after 25 years of disease duration. Using flow cytometry, DNA-aneuploidy was detected in 12 out of 59 patients, significantly correlating with low and high grade dysplasia.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1986

New unusual forms of colitis. Report of four cases with known and unknown etiology.

Four patients with colitis, in two of whom the etiology was unknown, are presented. One patient with discontinuous segmental colitis was infected by Aeromonas hydrophila, and another with presumed idiopathic inflammatory bowel disease was superinfected by this pathogen. Although Aeromonas hydrophila has been known as a rare cause of diarrhea in our region, it is in the first instance reported to cause severe long-lasting colitis as well as superinfection of idiopathic inflammatory bowel disease (IIBD). Another patient presented with segmental ischemic colitis which was rather atypical and of unknown etiology; the patient was young and had no predisposing factors for vascular occlusive disease. The fourth patient with long-lasting segmental granulomatous colitis which was suspected to be parasitic in origin remained without a definitive diagnosis. This presentation of patients with endoscopically proven colitis should in view of our increasing knowledge of colitis remind us to keep a look out for new infections and other forms of inflammatory bowel disease.

Adult↗
PubMed1980

[Clinical features of 27 cases of ischemic colitis (author's transl)].

The Authors report own experience of ischemic colitis, related to 27 cases, that includes either primitive forms (transient ischemic colitis, ischemic stricture and necrotic-gangrenous ischemic colitis) or secondary (occlusive ischemic colitis, ischemic colitis following abdominoperineal excision of the rectum). Pathogenetic findings, now not completely defined, are discussed with reference to the literature on this subject. The important diagnostic problems are also evaluated, particularly in the evaluation of radiologic and endoscopic findings of spontaneous ischemic colitis; these, altogether, represent an almost specific clinical picture of ischemic colitis. At last are considered the problems related to surgical treatment, overall in the forms in which the irreversibility of the ischemic lesions has been ascertained.

Aged↗
PubMed1979

Malignant potential of chronic ulcerative colitis. Preliminary report.

Prior studies confirm the increased incidence of carcinoma of the colon in chronic ulcerative colitis. The authors reviewed clinical and histologic data retrospectively in 23 patients with colon carcinoma and chronic ulcerative colitis. Twenty-two of these patients had dysplasia of colonic epithelium remote from the cancer. The authors prospectively reviewed clinical data and rectal and colonoscopic biopsy specimens on 36 patients with chronic ulcerative colitis, 12 with Crohn's colitis, and 12 with miscellaneous disorders. Eight patients with chronic ulcerative colitis had dysplasia; 6 have had colectomy, and 2 of these had carcinoma. No patient without chronic ulcerative colitis had dysplasia. Patients with chronic ulcerative colitis should have periodic rectal and colonoscopic biopsies, and those with moderate to marked dysplasia require colectomy because of the increased risk of colon carcinoma.

Adolescent↗
PubMed1995

[Local production of eicosanoids in patients with ulcerative colitis].

BACKGROUND: Eicosanoids act obviously as mediators of inflammation in ulcerative colitis. The objective of the submitted paper was to assess relations between intraluminal concentrations of prostaglandin E and leukotriene B4 and the activity of ulcerative colitis evaluated according to clinical, endoscopic and histological criteria. METHODS AND RESULTS: In 56 patients with ulcerative colitis the PGE concentration was assessed in the rectal dialysate (3H Prostaglandin E Radioimmunoassay Kit Ca-501, Clinical Assay Cambridge USA). In 35 patients with ulcerative colitis the authors assessed the LTB4 concentration in the rectal dialysate (Leukotriene B4 3H Assay RPN 70, Amersham, G. Britain). The authors proved a statistically significant correlation between the intraluminal PGE concentration and the activity of ulcerative colitis according to clinical criteria (p < 0.1), endoscopic criteria (p < 0.05) and histological criteria (p < 0.01). The intraluminal LTB4 concentration correlated significantly with the activity of ulcerative colitis according to clinical criteria (p < 0.05). When comparing LTB4 values with the activity of the disease according to endoscopic and histological criteria, a tendency of rising LTB4 values with increasing activity of the disease is apparent. However, a significant relationship was not found; this can be explained by the fact that relatively small groups of patients were investigated with a relatively great scatter of LTB4 concentrations. CONCLUSIONS: During the period of active ulcerative colitis the intraluminal PGE concentration rises and correlates with the clinical, endoscopic and histological activity. There is also a rise of the intraluminal LTB4 concentration which correlates with the clinical activity of the disease. A high eicosanoid concentration is found in cases with a severe course and complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Autoimmune hemolytic anemia, infrequent complication of ulcerative colitis].

Autoimmune hemolytic anemia is a rare complication of ulcerative colitis. A retrospective review of the cases of ulcerative colitis treated at our hospital between January 1984 and August 1993 showed that, among 210 patients, three presented autoimmune hemolytic anemia with a positive direct Coomb's test. They were two men and one woman suffering from a moderately active ulcerative colitis that affected the left colon. The hemolysis was diagnosed before the onset of colitis in two cases and after it in the other. In the only patient treated with sulphasalazine, this drug was stopped without improvement. All the patients were treated with steroids, with resolution of the anemia in one of them. Healing was achieved with splenectomy in the other two. Colectomy was not necessary in any case. After suppression of sulphasalazine and treatment with steroids, the next therapeutic option in patients with ulcerative colitis and autoimmune hemolytic anemia should be splenectomy, whereas colectomy should be only used with unresponsive patients, as well as with those affected by severe ulcerative colitis refractory to steroids. In patients presenting with ulcerative colitis and anemia, the possibility of autoimmune hemolytic anemia has to be considered since--in spite of being rare--it is responsive to proper treatment.

Adult↗
PubMed1994

Dietary and other risk factors of ulcerative colitis. A case-control study in Japan. Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan.

A multisite, hospital-based, case-control study examined the risk of ulcerative colitis in relation to dietary factors, smoking and drinking habits, past history of diseases, and childhood factors. Information was obtained from self-administered patient questionnaires. Study subjects included 101 ulcerative colitis patients who were 10-39 years old at the time of disease onset, which was within the previous 3 years, and 143 control subjects. Combined consumption of Western foods (bread for breakfast, butter, margarine, cheese, meats, and ham and sausage) was significantly related to an increased risk of ulcerative colitis (trend, p = 0.04). Margarine (as an individual Western food item) was positively associated with ulcerative colitis (trend, p = 0.005). There was also a tendency toward positive association of bread for breakfast with ulcerative colitis (trend, p = 0.07). The risk did not measurably vary with the consumption of typical Japanese foods, vegetables and fruits, confectioneries, or soft drinks. As compared with lifelong nonsmokers, current smokers tended to have a decreased risk of ulcerative colitis and former smokers had an increased risk. There was no association between breastfeeding in infancy and the risk of ulcerative colitis.

Adolescent↗
PubMed1993

[Undetermined colitis].

Indeterminate colitis combines features of chronic ulcerative colitis and Crohn's colitis and contemplates a dilemma for the patient and surgeon contemplating ileal pouch anal anastomosis. Some series have reported a high incidence of failure of pouch procedures in patients with indeterminate colitis. A series reported by the authors in 1989 reported a failure rate on approximately 9% with indeterminate colitis. In updating this series with additional patients operated on since that time, the incidence in our series approaches 20%. We feel that an 80% success rate, however, justifies performing the ileal pouch anal procedure in carefully selected patients with indeterminate colitis, knowing that the failure rate may be somewhat higher than in patients with type ordainer chronic ulcerative colitis.

Colitis↗
PubMed1994

Milk tolerance in adults with ulcerative colitis.

OBJECTIVES: There has been concern in the literature and among physicians and patients that milk intolerance may contribute to disease activity in ulcerative colitis. We sought to define whether patients with ulcerative colitis have problems with milk tolerance. METHODS: 1) A questionnaire was administered to a group of gastroenterologists. 2) Consecutive unselected ulcerative colitis patients were administered a questionnaire regarding issues concerning their ingestion and tolerance of milk products. 3) Patients, and age- and ethnically matched controls, underwent lactose hydrogen breath testing at a 50-g dose, and if intolerant, returned for testing at a 12.5-g dose. RESULTS: Eighty percent of responding physicians stated that they recommend avoidance of milk products at some time to their patients. Thirteen of 29 (44%) ulcerative colitis patients were lactose intolerant compared with five of 14 (36%) controls (p = 0.57). Of 11 subjects returning for the 12.5-g test dose, only three (28%) were intolerant. Of 10 ulcerative colitis patients tested during a flare, only two (20%) were intolerant. Nineteen of 28 (66%) patients reduced or eliminated milk products from their diet, but only 10 (45%) of these patients were lactose intolerant. The discordance rate for predicting lactose tolerance status among patients was 35%. By logistic regression analysis, age (p = 0.04) and ethnicity (p = 0.006) were the only variables that were predictive of an abnormal lactose hydrogen breath test. CONCLUSIONS: There are common misperceptions among physicians and patients about lactose intolerance in ulcerative colitis. Lactose intolerance in patients with ulcerative colitis is dependent on their age and ethnicity and not any particular aspects of their disease. The proscription of milk products during flares of disease by many physicians is not supported by this study.

Adult↗
PubMed1995

A case-control study of ulcerative colitis in relation to dietary and other factors in Japan. The Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan.

The etiology of ulcerative colitis is essentially unknown. A hospital-based case-control study examined the risk of ulcerative colitis in relation to dietary and other factors. Recruited at 20 hospitals across the nation were 101 ulcerative colitis patients who were 10-39 years old at the time of disease onset and whose disease had been diagnosed within the past 3 years. One hundred and forty-three control subjects were also examined. Information on factors was obtained by using a self-administered questionnaire. Combined consumption of western foods (bread for breakfast, butter, margarine, cheese, meats, and ham/ sausage) was significantly related to an increased risk of ulcerative colitis (trend P = 0.04). Of the six food items of the western food group, margarine was positively and significantly associated with ulcerative colitis (trend P = 0.005), and bread for breakfast tended to be positively associated with the risk (trend P = 0.07). No appreciable association was found for the consumption of Japanese foods, vegetables and fruits, confectionery, or soft drinks. Compared with lifelong nonsmokers, current smokers had a decreased risk, and former smokers had an increased risk. This study confirmed a protective association between smoking and ulcerative colitis, and suggested that margarine or chemically modified fat may play an etiological role in the development of ulcerative colitis.

Adolescent↗
PubMedDate not supplied

Differential activation of total and EGF receptor (EGF-R) tyrosine kinase (tyr-k) in the rectal mucosa in patients with adenomatous polyps, ulcerative colitis and colon cancer.

BACKGROUND/AIMS: Tyrosine kinase and a number of growth factors, especially EGF and TGF-alpha are known to stimulate proliferation in much of the gastrointestinal tract, including colon. In humans increased colonic mucosal proliferative activity has been observed in numerous premalignant lesions including adenomatous polyps and ulcerative colitis. The aim of the present study was to determine the differences of proliferative patterns in patients with adenomatous polyps, ulcerative colitis and colonic adenocarcinoma as reflected by rectal mucosa tyrosine kinase, EGF receptor tyrosine kinase and PCNA and to evaluate the role of tyr-k in colonic mucosal cell proliferation during carcinogenic process. MATERIALS AND METHODS: The study population comprised 40 patients, aged 17-74 years (mean 57), in which 10 patients had adenomatous polyps, 10-ulcerative colitis in remission phase, 10- colon adenocarcinoma and 10 healthy controls. After informed consent 6-8 rectal mucosal biopsy specimen were obtained at 10 cm from the anal verge at the beginning of the colonoscopy examination and at least 10 cm away from any macroscopic mucosal changes. RESULTS: Mean PCNA labeling indices in patients with colon adenocarcinoma, adenomatous polyps, ulcerative colitis ulcerosa and healthy controls were respectively: 27.6% +/- 5.75; 12.18% +/- 6.76; 10.9% +/- 5.34 and 1.5% +/- 0.97. PCNA labeling index in rectal mucosa of patients with adenomatous polyps, ulcerative colitis and colon cancer was significantly higher (p < 0.01) than in the control group. An upward expansion of the proliferative compartment was also observed in patients with premalignant and malignant colon conditions as regards to the control group. Total tyrosine kinase activity in the rectal mucosa of patients with polyps was elevated by 219%, with ulcerative colitis by 224% and with colorectal carcinoma by 600% as regards to the control group. EGF receptor tyrosine kinase was increased in colonic mucosa by 35.2% in patients with adenomatous polyps, by 40.6% in patients with ulcerative colitis and by 123% in patients with colon cancer. CONCLUSIONS: Increased values of this enzyme in the above mentioned group of patients may suggest that tyrosine phosphorylation represents an early sign of colonic mucosa susceptibility for cancer development. We conclude, that overall an EGF receptor-associated tyrosine kinase plays an important role in the development of hyperproliferative state of the colonic mucosa and colon carcinogenesis.

Adenocarcinoma↗
PubMed1998

Alterations in classical cadherins associated with progression in ulcerative and Crohn's colitis.

Human colitis is a condition associated with a spectrum of altered morphologic changes and cellular adhesion. The role of cadherins, which are powerful morphoregulatory cell adhesion molecules, in colitis is provocative and as yet unknown. Herein, we present results that suggest a strong correlation between the deregulation of two cadherin molecules, E- and P-cadherins, and the progression of human colitis. We examined the expression and structural integrity of E- and P-cadherins in inflamed, dysplastic, or neoplastic human ulcerative colitis (UC) (n=58), human Crohn's colitis (n = 30), and normal tissue (n = 20) to assess cadherin function in normal and abnormal epithelium. E-cadherin is strongly expressed in normal colorectal epithelium, whereas in left-sided UC it is either down-regulated or has a single-base pair mutation in exon 4 resulting in an amino acid alteration (6 of 58 UC cases). By contrast, P-cadherin is dramatically up-regulated in both Crohn's disease and ulcerative colitis and especially in dysplastic ulcerative tissue. In vitro transfected SW-480 colorectal cells containing E-cadherin mutations identical to those in vivo were associated with increased spontaneous disaggregation compared with cells transfected with wild-type E-cadherin. Based on this evidence, we hypothesize that a small subset of colorectal cells expressing mutant E-cadherin are associated with widespread ulceration, whereas those expressing P-cadherin are associated with a rapidly dividing immature phenotype that includes dysplasia. The differential expression of mutated and wild-type cadherins examined herein are associated with a broad spectrum of abnormal epithelial phenotypes, lymphocyte integrin binding, and resistance to denudation, as is seen in the colitis adenocarcinoma sequence.

Adult↗