Background: Previously, the association between inflammatory bowel disease (IBD) and the mucosal paracellular permeability change has been reported. A novel catheter that can measure mucosal admittance (MA) has been developed recently. In this study, we aimed to clarify the usefulness of measuring MA for predicting the prognosis of ulcerative colitis (UC) patients in remission.
Methods: Patients with UC in remission had been carried out real-time measurement of MA during colonoscopy and subsequent clinical follow up prospectively. The measurement of MA was taken by using the new device, Tissue Conductance Meter (TCM, AsahiBiomed Co., Ltd.), which can measure the mucosal permeability change electrophysiologically. Relapse was defined as moderate to severe clinical flare during the follow up period. We examined the relations between mucosal admittance, clinical parameters, and disease relapse during follow up period by the COX proportional hazards model.
Results: Fifty-four UC patients in remission were measured MA at baseline and studied for a median of 14 months. At baseline, the mean age was 44.8±13.8 years and 69% were males. The mean rectal MA of the patients was 906.7±264.3, and no complications were encountered by MA measurement.
In this prospective study, 23 patients (31.5%) relapsed, and in those patients, two patients (3.7%) underwent surgery during follow up period.
In the multivariate analysis, rectal MA in relapse group (801.2±207.1) was significantly lower than rectal MA in remission group (955.2±275.9, hazard ratio 0.998, 95% CI 0.996–1.000, p=0.046). The ROC curve analysis showed that the optimal cut-off value of rectal MA for relapse was 781.0 (AUROC =0.679, 95% CI: 0.529–0.829, p=0.036). In patients whose rectal MA was below the cut-off value, relapse rate was significantly more than for the other patients (Log rank test, p=0.002, Figure 1).
Conclusions: Our results showed that low levels of rectal MA are associated with relapse rate. Real-time measurement of rectal MA using a novel endoscopy-guided catheter could be safety and useful for predicting the prognosis of patients with UC in remission.