Original Article

Virchows Archiv

, Volume 448, Issue 4, pp 412-421

First online:

Infiltration of CD19+ plasma cells with frequent labeling of Ki-67 in corticosteroid-resistant active ulcerative colitis

  • Yoshio JinnoAffiliated withDepartment of Gastroenterology, Osaka City University Graduate School of MedicineDepartment of Internal Medicine, Division of Gastroenterology, Hyogo College of Medicine Email author 
  • , Haruo OhtaniAffiliated withDepartment of Pathology, National Hospital Organization Mito Medical CenterDepartment of Pathology, Tohoku University Graduate School of Medicine
  • , Shiro NakamuraAffiliated withDepartment of Gastroenterology, Osaka City University Graduate School of Medicine
  • , Motoji OkiAffiliated withDepartment of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Kiyoshi MaedaAffiliated withSurgical Oncology, Osaka City University Graduate School of Medicine
  • , Kohei FukushimaAffiliated withDepartment of Surgery, Tohoku University Graduate School of Medicine
  • , Hiroshi NaguraAffiliated withDepartment of Pathology, Tohoku University Graduate School of Medicine
  • , Nobuhide OshitaniAffiliated withDepartment of Gastroenterology, Osaka City University Graduate School of Medicine
  • , Takayuki MatsumotoAffiliated withDepartment of Gastroenterology, Osaka City University Graduate School of MedicineDepartment of Internal Medicine, Division of Gastroenterology, Hyogo College of Medicine
    • , Tetsuo ArakawaAffiliated withDepartment of Gastroenterology, Osaka City University Graduate School of Medicine

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Abstract

Abnormalities in humoral immunity are implicated in the pathogenesis of ulcerative colitis. However, the detailed mechanisms of B-cell activation in the locale remain unaccounted for. We analyzed ulcerative colitis from the standpoint of lymphocytic expansion in the loco. Intestinal specimens obtained at surgery from 30 patients with ulcerative colitis treated with corticosteroids and 15 with Crohn’s disease were analyzed by immunohistochemistry and flow cytometry. Ulcerative colitis was characterized by a diffuse distribution of Ki-67+ small round cells particularly in the ulcer base (that were CD19+ and CD20), with a significant number of them also CD138+. Immunoelectron microscopy for CD19 revealed an abundance of rough endoplasmic reticulum in the cytoplasm. These indicated that they are of immature plasma lineage cells. By contrast, plasma cells in Crohn’s disease were negative for CD19, and the labeling for Ki-67 was infrequent, showing mature phenotype. Flow cytometry revealed an occurrence of CD19+ and CD20 cells in ulcerative colitis but not in Crohn’s disease. The labeling index of Ki-67 among CD19+ plasma cells was positively correlated with the clinical activity of ulcerative colitis. High labeling of Ki-67 in CD19+ plasma cells is specific for active ulcerative colitis that was resistant to medical treatment by corticosteroids.

Keywords

Ulcerative colitis Ki-67 B-lineage cells Plasma cells