%0 Journal Article
%T Endoscopic alterations in Peyer's patches in patients with ulcerative colitis: A prospective, multicenter study.
%A Hiyama S
%A Iijima H
%A Sakakibara Y
%A Yamada T
%A Mukai A
%A Otake Y
%A Yamaguchi T
%A Araki M
%A Kawai S
%A Tsujii Y
%A Inoue T
%A Hayashi Y
%A Shinzaki S
%A Takehara T
%J J Gastroenterol Hepatol
%V 35
%N 7
%D Jul 2020
%M 31734952
%F 4.369
%R 10.1111/jgh.14933
%X <B>OBJECTIVE: </B>Peyer's patches (PPs) play a major role in intestinal mucosal immunity; however, their role in ulcerative colitis (UC) is not well investigated. We evaluated endoscopic features of PPs on narrow-band imaging with magnifying endoscopy (NBI-ME) and investigated their association with clinical factors.<BR><B>METHODS: </B>We prospectively recruited 105 patients with UC, 18 with Crohn's disease, 16 with disease control, and 33 healthy control subjects at three institutions from 2014 to 2017. NBI-ME images of the villi of PPs were evaluated according to the Villi Index, and patients were divided into the Villi Index low (L) and high (H) types. The 1-year sustained clinical remission rate was evaluated between L-type and H-type PPs in patients with UC.<BR><B>RESULTS: </B>The proportions of patients with H-type PPs were significantly higher among UC, Crohn's disease, and disease control patients than among healthy control patients (P = 0.0125, 0.018, 0.0007). In UC, age, gender, endoscopic score, and extent of disease involvement were not significantly different between L-type and H-type PPs, whereas the sustained clinical remission rate was significantly higher in L-type PPs than in H-type PPs (88% [57/65] vs 65% [17/26], P = 0.019). Multivariate analysis revealed that the L type of PPs was a significant factor for sustained clinical remission (odds ratio 3.8, 95% confidence interval 1.1-12.9, P = 0.033).<BR><B>CONCLUSIONS: </B>Patients with UC showed endoscopic alterations in PPs on NBI-ME, and highly altered appearance of PPs can be associated with a high risk of clinical relapse in patients with UC.