Микроскопический колит с позиций современной гастроэнтерологии
Микроскопический колит с позиций современной гастроэнтерологии
Андреев Д.Н., Маев И.В., Кучерявый Ю.А., Черёмушкин С.В. Микроскопический колит с позиций современной гастроэнтерологии. Consilium Medicum. 2021; 23 (5): 395–401.
DOI: 10.26442/20751753.2021.5.200888
________________________________________________
Andreev DN, Maev IV, Kucheryavyy YA, Cheremushkin SV. Microscopic colitis from the standpoint of modern gastroenterology. Consilium Medicum. 2021; 23 (5): 395–401. DOI: 10.26442/20751753.2021.5.200888
Микроскопический колит с позиций современной гастроэнтерологии
Андреев Д.Н., Маев И.В., Кучерявый Ю.А., Черёмушкин С.В. Микроскопический колит с позиций современной гастроэнтерологии. Consilium Medicum. 2021; 23 (5): 395–401.
DOI: 10.26442/20751753.2021.5.200888
________________________________________________
Andreev DN, Maev IV, Kucheryavyy YA, Cheremushkin SV. Microscopic colitis from the standpoint of modern gastroenterology. Consilium Medicum. 2021; 23 (5): 395–401. DOI: 10.26442/20751753.2021.5.200888
Микроскопический колит – это хроническое воспалительное заболевание кишечника неизвестной этиологии, характеризующееся хронической водянистой диареей, отсутствием макроскопических признаков поражения толстой кишки при наличии специфических патоморфологических изменений. В настоящей обзорной статье рассмотрены современные представления о микроскопическом колите, включая его дефиницию, эпидемиологию, факторы риска, клиническую картину, критерии диагностики и тактику лечения через призму последних европейских клинических рекомендаций UEG/EMCG (2021 г.).
Microscopic colitis is a chronic inflammatory bowel disease of unknown etiology, characterized by chronic watery diarrhea, the absence of macroscopic signs of colon lesions in the presence of specific pathological changes. This review article presents the current view on microscopic colitis, including its definition, epidemiology, risk factors, clinical manifestations, diagnostic criteria and treatment tactics according to the last European clinical guidelines UEG/EMCG (2021).
1. Lindström CG. 'Collagenous colitis' with watery diarrhoea – a new entity? Pathol Eur. 1976;11:87-9.
2. Маев И.В., Кучерявый Ю.А., Андреев Д.Н., Черёмушкин С.В. Эволюция представлений о микроскопическом колите. Терапевтический архив. 2015;87(4):69-76 [Maev IV, Kucheriavyi IuA, Andreev DN, Cheremushkin SV. Evoliutsiia predstavlenii o mikroskopicheskom kolite. Terapevticheskii Arkhiv. 2015;87(4):69-76 (in Russian)].
3. Münch A, Aust D, Bohr J, et al; European Microscopic Colitis Group (EMCG). Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6(9):932-45.
4. Маев И.В., Кучерявый Ю.А., Андреев Д.Н., Черёмушкин С.В. Микроскопический колит: этиопатогенез, диагностика и лечение. М., 2018 [Maev IV, Kucheryavyy YuA, Andreev DN, Cheremushkin SV. Microscopic colitis: etiopathogenesis, diagnosis and treatment. Moscow, 2018 (in Russian)].
5. Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22. DOI:10.1177/2050640620951905
6. Shor J, Churrango G, Hosseini N, Marshall C. Management of microscopic colitis: challenges and solutions. Clin Exp Gastroenterol. 2019;12:111-20. DOI:10.2147/CEG.S165047
7. Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis. 2020;jjaa108. DOI:10.1093/ecco-jcc/jjaa108
8. Bergman D, Clements MS, Khalili H, et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther. 2019;49(11):1395-400. DOI:10.1111/apt.15246
9. Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015;110(2):265-76. DOI:10.1038/ajg.2014.431
10. Fernández-Bañares F, Zabana Y, Aceituno M, et al. Prevalence and Natural History of Microscopic Colitis: A Population-Based Study With Long-term Clinical Follow-up in Terrassa, Spain. J Crohns Colitis. 2016;10(7):805-11. DOI:10.1093/ecco-jcc/jjw037
11. Bohr J, Tysk C, Eriksson S, Järnerot G. Collagenous colitis in Orebro, Sweden, an epidemiological study 1984–1993. Gut. 1995;37(3):394-7. DOI:10.1136/gut.37.3.394
12. El-Matary W, Girgis S, Huynh H, et al. Microscopic colitis in children. Dig Dis Sci. 2010;55(7):1996-2001. DOI:10.1007/s10620-009-0964-4
13. Jaruvongvanich V, Poonsombudlert K, Ungprasert P. Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. 2019;25(4):672-8.
14. Al Momani L, Balagoni H, Alomari M, et al. The association between smoking and both types of microscopic colitis: A systematic review and meta-analysis. Arab J Gastroenterol. 2020;21(1):9-18.
15. Beaugerie L, Pardi DS. Review article: drug-induced microscopic colitis – proposal for a scoring system and review of the literature. Aliment Pharmacol Ther. 2005;22:277-84.
16. Fernández-Bañares F, de Sousa MR, Salas A, et al. Epidemiological risk factors in microscopic colitis: a prospective case-control study. Inflamm Bowel Dis. 2013;19:411-7.
17. Storr MA. Microscopic colitis: epidemiology, pathophysiology, diagnosis and current management-an update 2013. ISRN Gastroenterol. 2013;2013:352718.
18. Cindoruk M, Tuncer C, Dursun A, et al. Increased colonic intraepithelial lymphocytes in patients with Hashimoto’s thyroiditis. J Clin Gastroenterol. 2002;34(3):237-9.
19. Freeman HJ. Collagenous colitis as the presenting feature of biopsy-defined celiac disease. J Clin Gastroenterol. 2004;38(8):664-8.
20. Williams JJ, Kaplan GG, Makhija S, et al. Microscopic colitis-defining incidence rates and risk factors: a population-based study. Clin Gastroenterol Hepatol. 2008;6(1):35-40.
21. Koskela RM, Niemelä SE, Karttunen TJ, Lehtola JK. Clinical characteristics of collagenous and lymphocytic colitis. Scand J Gastroenterol. 2004;39(9):837-45.
22. Miehlke S, Verhaegh B, Tontini GE, et al. Microscopic colitis: pathophysiology and clinical management. Lancet Gastroenterol Hepatol. 2019;4(4):305-14.
23. Stahl E, Roda G, Dobbyn A, et al. Collagenous Colitis Is Associated With HLA Signature and Shares Genetic Risks With Other Immune-Mediated Diseases. Gastroenterology. 2020;159(2):549-561.e8.
24. Fine KD, Do K, Schulte K, et al. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol. 2000;95:1974-82.
25. Fernandez-Banares F, Esteve M, Farre C, et al. Predisposing HLA-DQ2 and HLA-DQ8 haplotypes of coeliac disease and associated enteropathy in microscopic colitis. Eur J Gastroenterol Hepatol. 2005;17:1333-8.
26. Münch A, Söderholm JD, Wallon C, et al. Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy. Gut. 2005;54(8):1126-8. DOI:10.1136/gut.2004.058750
27. Barmeyer C, Erko I, Fromm A, et al. Ion transport and barrier function are disturbed in microscopic colitis. Ann N Y Acad Sci. 2012;1258:143-8. DOI:10.1111/j.1749-6632.2012.06631.x
28. Barmeyer C, Erko I, Awad K, et al. Epithelial barrier dysfunction in lymphocytic colitis through cytokine-dependent internalization of claudin-5 and -8. J Gastroenterol. 2017;52(10):1090-100. DOI:10.1007/s00535-017-1309-2
29. Norén E, Mellander MR, Almer S, Söderman J. Genetic Variation and Gene Expression Levels of Tight Junction Genes Indicates Relationships Between PTEN as well as MAGI1 and Microscopic Colitis. Dig Dis Sci. 2018;63(1):105-12.
30. Nielsen HL, Dalager-Pedersen M, Nielsen H. High risk of microscopic colitis after Campylobacter concisus infection: population-based cohort study. Gut. 2020;69(11):1952-8. DOI:10.1136/gutjnl-2019-319771
31. Khalili H, Axelrad JE, Roelstraete B, et al. Gastrointestinal Infection and Risk of Microscopic Colitis: A Nationwide Case-Control Study in Sweden. Gastroenterology. 2021;160(5):1599-1607.e5. DOI:10.1053/j.gastro.2021.01.004
32. Tagkalidis PP, Gibson PR, Bhathal PS. Microscopic colitis demonstrates a T helper cell type 1 mucosal cytokine profile. J Clin Pathol. 2007;60(4):382-7. DOI:10.1136/jcp.2005.036376
33. Kumawat AK, Strid H, Tysk C, et al. Microscopic colitis patients demonstrate a mixed Th17/Tc17 and Th1/Tc1 mucosal cytokine profile. Mol Immunol. 2013;55(3-4):355-64.
DOI:10.1016/j.molimm.2013.03.007
34. Kane JS, Irvine AJ, Derwa Y, Ford AC. Fatigue and its associated factors in microscopic colitis. Therap Adv Gastroenterol. 2018;11:1756284818799599. DOI:10.1177/1756284818799599
35. Tromm A. Microscopic colitis. Bremen: UNI-MED, 2012.
36. Andrews CN, Beck PL, Wilsack LH, et al. Evaluation of endoscopist and pathologist factors affecting the incidence of microscopic colitis. Can J Gastroenterol. 2012;26:515-20.
37. Virine B, Chande N, Driman DK. Biopsies From Ascending and Descending Colon Are Sufficient for Diagnosis of Microscopic Colitis. Clin Gastroenterol Hepatol. 2020;18(9):2003-9.
38. Tome J, Kamboj AK, Pardi DS. Microscopic Colitis: A Concise Review for Clinicians. Mayo Clin Proc. 2021;96(5):1302-8.
39. Barrett K. Microscopic colitis: a guide for general practice. Br J Gen Pract. 2020;71(702):41-2.
40. Guslandi M. Microscopic colitis: a therapeutic challenge. World J Gastroenterol. 2013;19(23):3531-3.
41. Chande N, MacDonald JK, McDonald JWD. Interventions for treating microscopic colitis: a Cochrane inflammatory bowel disease and functional bowel disorders review group systematic review of randomized trials. Am J Gastroenterol. 2009;104(1):235-41.
42. Stewart MJ, Seow CH, Storr MA. Prednisolone and budesonide for short- and long-term treatment of microscopic colitis: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2011;9(10):881-90.
43. Sebastian S, Wilhelm A, Jessica L, et al. Budesonide treatment for microscopic colitis: systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2019;31(8):919-27.
44. Miehlke S, Madisch A, Bethke B, et al. Stolte Oral budesonide for maintenance treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2008;135:1510-6.
45. Bonderup OK, Hansen JB, Teglbjaerg PS, et al. Long-term budesonide treatment of collagenous colitis – a randomised, double-blind, placebo-controlled trial. Gut. 2009;58:68-72.
________________________________________________
1. Lindström CG. 'Collagenous colitis' with watery diarrhoea – a new entity? Pathol Eur. 1976;11:87-9.
2. Maev IV, Kucheriavyi IuA, Andreev DN, Cheremushkin SV. Evoliutsiia predstavlenii o mikroskopicheskom kolite. Terapevticheskii Arkhiv. 2015;87(4):69-76 (in Russian)
3. Münch A, Aust D, Bohr J, et al; European Microscopic Colitis Group (EMCG). Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012;6(9):932-45.
4. Maev IV, Kucheryavyy YuA, Andreev DN, Cheremushkin SV. Microscopic colitis: etiopathogenesis, diagnosis and treatment. Moscow, 2018 (in Russian)
5. Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22. DOI:10.1177/2050640620951905
6. Shor J, Churrango G, Hosseini N, Marshall C. Management of microscopic colitis: challenges and solutions. Clin Exp Gastroenterol. 2019;12:111-20. DOI:10.2147/CEG.S165047
7. Weimers P, Ankersen DV, Lophaven S, et al. Incidence and prevalence of microscopic colitis between 2001 and 2016: A Danish nationwide cohort study. J Crohns Colitis. 2020;jjaa108. DOI:10.1093/ecco-jcc/jjaa108
8. Bergman D, Clements MS, Khalili H, et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther. 2019;49(11):1395-400. DOI:10.1111/apt.15246
9. Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015;110(2):265-76. DOI:10.1038/ajg.2014.431
10. Fernández-Bañares F, Zabana Y, Aceituno M, et al. Prevalence and Natural History of Microscopic Colitis: A Population-Based Study With Long-term Clinical Follow-up in Terrassa, Spain. J Crohns Colitis. 2016;10(7):805-11. DOI:10.1093/ecco-jcc/jjw037
11. Bohr J, Tysk C, Eriksson S, Järnerot G. Collagenous colitis in Orebro, Sweden, an epidemiological study 1984–1993. Gut. 1995;37(3):394-7. DOI:10.1136/gut.37.3.394
12. El-Matary W, Girgis S, Huynh H, et al. Microscopic colitis in children. Dig Dis Sci. 2010;55(7):1996-2001. DOI:10.1007/s10620-009-0964-4
13. Jaruvongvanich V, Poonsombudlert K, Ungprasert P. Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. 2019;25(4):672-8.
14. Al Momani L, Balagoni H, Alomari M, et al. The association between smoking and both types of microscopic colitis: A systematic review and meta-analysis. Arab J Gastroenterol. 2020;21(1):9-18.
15. Beaugerie L, Pardi DS. Review article: drug-induced microscopic colitis – proposal for a scoring system and review of the literature. Aliment Pharmacol Ther. 2005;22:277-84.
16. Fernández-Bañares F, de Sousa MR, Salas A, et al. Epidemiological risk factors in microscopic colitis: a prospective case-control study. Inflamm Bowel Dis. 2013;19:411-7.
17. Storr MA. Microscopic colitis: epidemiology, pathophysiology, diagnosis and current management-an update 2013. ISRN Gastroenterol. 2013;2013:352718.
18. Cindoruk M, Tuncer C, Dursun A, et al. Increased colonic intraepithelial lymphocytes in patients with Hashimoto’s thyroiditis. J Clin Gastroenterol. 2002;34(3):237-9.
19. Freeman HJ. Collagenous colitis as the presenting feature of biopsy-defined celiac disease. J Clin Gastroenterol. 2004;38(8):664-8.
20. Williams JJ, Kaplan GG, Makhija S, et al. Microscopic colitis-defining incidence rates and risk factors: a population-based study. Clin Gastroenterol Hepatol. 2008;6(1):35-40.
21. Koskela RM, Niemelä SE, Karttunen TJ, Lehtola JK. Clinical characteristics of collagenous and lymphocytic colitis. Scand J Gastroenterol. 2004;39(9):837-45.
22. Miehlke S, Verhaegh B, Tontini GE, et al. Microscopic colitis: pathophysiology and clinical management. Lancet Gastroenterol Hepatol. 2019;4(4):305-14.
23. Stahl E, Roda G, Dobbyn A, et al. Collagenous Colitis Is Associated With HLA Signature and Shares Genetic Risks With Other Immune-Mediated Diseases. Gastroenterology. 2020;159(2):549-561.e8.
24. Fine KD, Do K, Schulte K, et al. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol. 2000;95:1974-82.
25. Fernandez-Banares F, Esteve M, Farre C, et al. Predisposing HLA-DQ2 and HLA-DQ8 haplotypes of coeliac disease and associated enteropathy in microscopic colitis. Eur J Gastroenterol Hepatol. 2005;17:1333-8.
26. Münch A, Söderholm JD, Wallon C, et al. Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy. Gut. 2005;54(8):1126-8. DOI:10.1136/gut.2004.058750
27. Barmeyer C, Erko I, Fromm A, et al. Ion transport and barrier function are disturbed in microscopic colitis. Ann N Y Acad Sci. 2012;1258:143-8. DOI:10.1111/j.1749-6632.2012.06631.x
28. Barmeyer C, Erko I, Awad K, et al. Epithelial barrier dysfunction in lymphocytic colitis through cytokine-dependent internalization of claudin-5 and -8. J Gastroenterol. 2017;52(10):1090-100. DOI:10.1007/s00535-017-1309-2
29. Norén E, Mellander MR, Almer S, Söderman J. Genetic Variation and Gene Expression Levels of Tight Junction Genes Indicates Relationships Between PTEN as well as MAGI1 and Microscopic Colitis. Dig Dis Sci. 2018;63(1):105-12.
30. Nielsen HL, Dalager-Pedersen M, Nielsen H. High risk of microscopic colitis after Campylobacter concisus infection: population-based cohort study. Gut. 2020;69(11):1952-8. DOI:10.1136/gutjnl-2019-319771
31. Khalili H, Axelrad JE, Roelstraete B, et al. Gastrointestinal Infection and Risk of Microscopic Colitis: A Nationwide Case-Control Study in Sweden. Gastroenterology. 2021;160(5):1599-1607.e5. DOI:10.1053/j.gastro.2021.01.004
32. Tagkalidis PP, Gibson PR, Bhathal PS. Microscopic colitis demonstrates a T helper cell type 1 mucosal cytokine profile. J Clin Pathol. 2007;60(4):382-7. DOI:10.1136/jcp.2005.036376
33. Kumawat AK, Strid H, Tysk C, et al. Microscopic colitis patients demonstrate a mixed Th17/Tc17 and Th1/Tc1 mucosal cytokine profile. Mol Immunol. 2013;55(3-4):355-64.
DOI:10.1016/j.molimm.2013.03.007
34. Kane JS, Irvine AJ, Derwa Y, Ford AC. Fatigue and its associated factors in microscopic colitis. Therap Adv Gastroenterol. 2018;11:1756284818799599. DOI:10.1177/1756284818799599
35. Tromm A. Microscopic colitis. Bremen: UNI-MED, 2012.
36. Andrews CN, Beck PL, Wilsack LH, et al. Evaluation of endoscopist and pathologist factors affecting the incidence of microscopic colitis. Can J Gastroenterol. 2012;26:515-20.
37. Virine B, Chande N, Driman DK. Biopsies From Ascending and Descending Colon Are Sufficient for Diagnosis of Microscopic Colitis. Clin Gastroenterol Hepatol. 2020;18(9):2003-9.
38. Tome J, Kamboj AK, Pardi DS. Microscopic Colitis: A Concise Review for Clinicians. Mayo Clin Proc. 2021;96(5):1302-8.
39. Barrett K. Microscopic colitis: a guide for general practice. Br J Gen Pract. 2020;71(702):41-2.
40. Guslandi M. Microscopic colitis: a therapeutic challenge. World J Gastroenterol. 2013;19(23):3531-3.
41. Chande N, MacDonald JK, McDonald JWD. Interventions for treating microscopic colitis: a Cochrane inflammatory bowel disease and functional bowel disorders review group systematic review of randomized trials. Am J Gastroenterol. 2009;104(1):235-41.
42. Stewart MJ, Seow CH, Storr MA. Prednisolone and budesonide for short- and long-term treatment of microscopic colitis: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2011;9(10):881-90.
43. Sebastian S, Wilhelm A, Jessica L, et al. Budesonide treatment for microscopic colitis: systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2019;31(8):919-27.
44. Miehlke S, Madisch A, Bethke B, et al. Stolte Oral budesonide for maintenance treatment of collagenous colitis: a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2008;135:1510-6.
45. Bonderup OK, Hansen JB, Teglbjaerg PS, et al. Long-term budesonide treatment of collagenous colitis – a randomised, double-blind, placebo-controlled trial. Gut. 2009;58:68-72.
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия;
2 АО «Ильинская больница», д. Глухово, Московская область, Россия
*dna-mit8@mail.ru
________________________________________________
Dmitrii N. Andreev*1, Igor V. Maev1, Yury A. Kucheryavyy2, Sergei V. Cheremushkin1
1 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
2 Ilyinskaya Hospital, Glukhovo, Moscow Region, Russia
*dna-mit8@mail.ru