ABSTRACT
Canine Chronic Ulcerative Stomatitis is a spontaneously occurring inflammatory disease of the oral mucosa. An immune-mediated pathogenesis is suspected though not yet proven. We have recently reported on the clinical and histologic features, and identification of select leukocyte cell populations within the lesion. A clinical and histologic similarity to oral lichen planus of people was proposed. In the present study, these initial observations are extended by examining lesions from 24 dogs with clinical evidence of chronic ulcerative stomatitis. Because dogs with chronic ulcerative stomatitis often have concurrent periodontal disease, we wondered if dental plaque/biofilm may be a common instigator of inflammation in both lesions. We hypothesized that dogs with chronic ulcerative stomatitis would exhibit a spectrum of pathologic changes and phenotype of infiltrating leukocytes that would inform lesion pathogenesis and that these changes would differ from inflammatory phenotypes in periodontitis. Previously we identified chronic ulcerative stomatitis lesions to be rich in FoxP3+ and IL17+ cells. As such, we suspect that these leukocytes play an important role in lesion pathogenesis. The current study confirms the presence of moderate to large numbers of FoxP3+ T cells and IL17+ cells in all ulcerative stomatitis lesions using confocal immunofluorescence. Interestingly, the majority of IL17+ cells were determined to be non-T cells and IL17+ cell frequencies were negatively correlated with severity on the clinical scoring system. Three histologic subtypes of ulcerative stomatitis were determined; lichenoid, deep stomatitis and granulomatous. Periodontitis lesions, like stomatitis lesions, were B cell and plasma cell rich, but otherwise differed from the stomatitis lesions. Direct immunofluorescence results did not support an autoantibody-mediated autoimmune disease process. This investigation contributes to the body of literature regarding leukocyte involvement in canine idiopathic inflammatory disease pathogenesis.
Subject(s)
Dog Diseases/immunology , Gingivitis, Necrotizing Ulcerative/immunology , Animals , Chronic Disease , Diagnosis, Differential , Dog Diseases/pathology , Dogs , Fluorescent Antibody Technique, Direct , Gingivitis, Necrotizing Ulcerative/diagnosis , Gingivitis, Necrotizing Ulcerative/pathology , Gingivitis, Necrotizing Ulcerative/veterinary , Inflammation/etiology , Leukocytes/pathology , Mouth Mucosa/pathology , Periodontal Diseases/diagnosisABSTRACT
Objetivo. La enfermedad inflamatoria intestinal (EII) tiene una evolución crónica recidivante. No existe ningún método específico para detectar a los pacientes con riesgo elevado de recaída. El objetivo del trabajo ha sido analizar el valor pronóstico de la gammagrafía con leucocitos- 99mTc-HMPAO (GLM) realizada durante un ataque agudo de EII. Material y métodos. Se han estudiado 18 pacientes (32 ± 10 años) con sospecha de un ataque agudo de EII (5 colitis ulcerosa [CU] y 13 enfermedad de Crohn [EC]). Se excluyeron los que habían recibido tratamiento con esteroides o con immunosupresores durante el año anterior. Se obtuvo una GLM en condiciones basales y otra a las 3 semanas de tratamiento esteroideo y se calculó el índice de actividad gammagráfica (IAG). Se practicó una colonoscopia y se calcularon los índices clínico-analíticos, índice de actividad de la EC (Crohn's disease activity index [CDAI]) en la EC y Truelove en la CU. Los pacientes fueron evaluados clínicamente durante un año. En la evolución se valoraron la respuesta o no al tratamiento inicial y la necesidad de nuevas terapias. Resultados. Todos los pacientes con CU y 4 pacientes con EC mostraron una disminución de IAG > 50 %, presentando una buena evolución clínica. Sólo 2 de los otros 9 pacientes con EC mostraron una disminución de IAG 50 % a las 3 semanas de tratamiento esteroideo indica una buena evolución clínica y hace poco probable la aparición de nuevos brotes
Objective. The inflammatory bowel disease (EII) has a chronic evolution with a frequent relapses. There is no specific diagnosis method to detect the patients with a high risk to relapse. The aim of the work was to analyse the prognostic value of 99mTc-HMPAO leukocyte scintigraphy (LS) performed during an acute attack of EII. Material and methods. 18 patients (mean age 32 ± 10 years) admitted for an acute attack of EII has been prospectively studied (5 ulcerative colitis [UC] and 13 Cronh's disease [CD]), excluding patient with prior steroids or immunosuppressive therapy during the last year. LS were obtained in basal conditions and following 3 weeks of steroid treatment and the scintigraphic activity index (SAI) has been calculated. Colonoscopy has been done in all patients, and CDAI in CD and Truelove index in UC have been calculated. Patients were followed up for 1 year. In the evolution the therapy requirements as well as the good response to initial treatment have been evaluated. Results. All patients with UC and 4 patients with CD showed a SAI decrease > 50 % and all had a good clinical evolution. Only 2 out of the 9 patients with CD showing a IAG decrease 50 % at 3 weeks of steroid treatment indicates a good clinical evolution
