TABLE 2.
Summary of the ultrastructural lesions identified in human CD and UC.
| Tissue | Lesions in CD | Lesions in UC |
|---|---|---|
| Luminal epithelium | • Focal loss of the epithelium (Dvorak and Dickersin, 1979; Dvorak et al., 1979; Marin et al., 1983) | • Focal loss of the epithelium (Delpre et al., 1989) |
| • Increased mucus secretion (Dvorak and Dickersin, 1979; Dvorak et al., 1979; Bertini et al., 1998) | • Reduction in the number of crypts and crypt openings (Shields et al., 1985; Bertini et al., 1998) | |
| • Glycocalyx reduction or loss (Bertini et al., 1998) | • Crypt lesions (deformation, furrows, atrophy, and/or distorted and dilated openings) (Shields et al., 1985; Bertini et al., 1998; Fratila and Craciun, 2010) | |
| • Crypt opening dilatation (Marin et al., 1983) | • Increase in the number of undifferentiated, immature cells (Mughal and Filipe, 1992) | |
| • Microulcerations (1–6 cells in diameter) (Marin et al., 1983) | • Enterocytes | |
| • Increase in the number of undifferentiated, immature cells (Mughal and Filipe, 1992) | - Distortion and loss of hexagonal shape (Kavin et al., 1970; Shields et al., 1985) | |
| • Enterocytes | - Microvillus alterations (shortening, enlargement, and vacuolization) or loss (Myllarniemi and Nickels, 1980; Delpre et al., 1989; Mughal and Filipe, 1992; Bertini et al., 1998; Fratila and Craciun, 2010) | |
| - Cell bridging or building (Marin et al., 1983; Nyhlin and Stenling, 1984; Nagel et al., 1995) | - Hyperplasia and/or hypertrophy (Shields et al., 1985; Mughal and Filipe, 1992; Bertini et al., 1998) | |
| - Loss of hexagonal shape (Myllarniemi and Nickels, 1980; Marin et al., 1983; Nyhlin and Stenling, 1984) | - Large apical lysosomes (Bertini et al., 1998), cytoplasmic vacuolization (Delpre et al., 1989; Fratila and Craciun, 2010), and/or increase in the number of electron-dense vesicles (Mughal and Filipe, 1992) | |
| - Tight junction fragmentation or loss (Marin et al., 1983) | - ER swelling (Delpre et al., 1989) | |
| - Microvillus alterations (shortening, thickening, enlargement, and fusion) or loss (Dvorak and Dickersin, 1979, 1980; Dvorak et al., 1979; Rickert and Carter, 1980; Marin et al., 1983; Nyhlin and Stenling, 1984; Nagel et al., 1995; Bertini et al., 1998) | - Golgi zone swelling (Delpre et al., 1989) | |
| - Abnormal small electron-dense, microvillus- and desmosome-associated bodies (Lewis et al., 1984) | - Irregular, pycnotic nuclei (Mughal and Filipe, 1992; Fratila and Craciun, 2010) with a loosely arranged nuclear membrane (Mughal and Filipe, 1992) | |
| - Increase in the number of electron-dense lysosomal granules (Ranlov et al., 1972; Dvorak and Dickersin, 1980; Thyberg et al., 1981; Marin et al., 1983) | - Mitochondrial alterations (swelling with disarranged cristae) (Delpre et al., 1989; Fratila and Craciun, 2010) | |
| - Mitochondrial lesions or pleomorphy (swelling with disarranged cristae) (Ranlov et al., 1972; Mughal and Filipe, 1992; Nazli et al., 2004) | - Pseudopod-like extensions of the cell membrane (Delpre et al., 1989) | |
| - ER swelling (Ranlov et al., 1972) | - Dilation of the intercellular space (Delpre et al., 1989) | |
| - Nuclei with a loosely arranged nuclear membrane (Mughal and Filipe, 1992) | • Goblet cells | |
| • Goblet cells | - Hypoplasia (Kavin et al., 1970; Myllarniemi and Nickels, 1980; Bertini et al., 1998; Fratila and Craciun, 2010) or hyperplasia (Mughal and Filipe, 1992) | |
| - Orifice dilation (Dvorak and Dickersin, 1979; Dvorak et al., 1979; Marin et al., 1983) | - ER swelling (Fratila and Craciun, 2010) | |
| - Hyperplasia and/or hypertrophy (Dvorak et al., 1979; Myllarniemi and Nickels, 1980; Marin et al., 1983; Nagel et al., 1995) | - Heterogeneity (Mughal and Filipe, 1992) and decrease (Delpre et al., 1989) of mucin droplets | |
| - Immature mucigenic granules (Dvorak and Dickersin, 1980) | ||
| - Abnormal small electron-dense, microvillus- and desmosome-associated bodies (Lewis et al., 1984) | ||
| • Paneth cells | ||
| - Irregular lysosomal inclusions/increased granule formation in Golgi areas (Dvorak and Dickersin, 1980) | ||
| - Hyperplasia (Dvorak and Dickersin, 1980) | ||
| Connective tissue and vasculature | • Extracellular edema with marked infiltrates of inflammatory cells (Ranlov et al., 1972; Thyberg et al., 1981; Brewer et al., 1990) | • Marked infiltrates of inflammatory cells (Delpre et al., 1989; Brewer et al., 1990) |
| • Activated fibroblasts and extracellular fibrin deposition (Ranlov et al., 1972) | • Lymphatics | |
| • Fragmented or irregularly arranged collagen (Dvorak et al., 1980b) | - Intracellular edema in endothelial cells (Aluwihare, 1971) | |
| • Lymphatics | ||
| - Distension (Dvorak et al., 1980a) | ||
| - Large inter-endothelial gaps (Dvorak et al., 1980a) | ||
| • Arterioles and arteries | ||
| - Intimal proliferation (Dvorak et al., 1980a) | ||
| - Fragmented elastic tissue (Dvorak et al., 1980a) | ||
| - Increased adventitial collagen (Dvorak et al., 1980a) | ||
| • Capillaries | ||
| - Endothelial swelling (Brewer et al., 1990) | ||
| • Venules | ||
| - Lumen filled with platelets and fibrin strands (Dvorak et al., 1980a) | ||
| - Focal endothelial necrosis (Dvorak et al., 1980a) | ||
| - Endothelial cells and pericytes with non-membrane-bound lipid bodies (Dvorak et al., 1980a) | ||
| - Basal lamina reduplications | ||
| • Macrophages | ||
| - Increase in the number of electron-dense lysosomal granules (Thyberg et al., 1981) | ||
| • Mast cells | ||
| - Granule alterations (size, number, and density/degranulation) (Dvorak et al., 1980a; Wang et al., 2007) | ||
| - Elongated surface villi (Dvorak et al., 1980a) | ||
| • Basophils | ||
| - Degranulation (Dvorak et al., 1980a) | ||
| • Eosinophils | ||
| - Granule alterations (size, number, and density) (Dvorak et al., 1980a) | ||
| • Lymphocytes | ||
| - Prominent nucleoli (Aluwihare, 1971) | ||
| • Lymphoid cells | ||
| - Poly-ribosomal structures (Ranlov et al., 1972) | ||
| - Golgi zone enlargement (Ranlov et al., 1972) | ||
| Musculature | • Smooth muscle cells | • Interstitial cells of Cajal |
| - Hyperplasia and/or hypertrophy (Dvorak et al., 1980b) | - Lipid droplets (Rumessen, 1996; Rumessen et al., 2010) | |
| - Necrosis (Dvorak et al., 1980b) | - Disrupted glycogen vacuoles (Rumessen, 1996) and irregular vacuoles (Rumessen et al., 2010) | |
| - Cytoplasmic vacuoles with collagen fibers or lipids (Dvorak et al., 1980b) | ||
| - Hypercontraction (Dvorak et al., 1980b) | ||
| - Myofibroblastic transformation (Dvorak et al., 1980b) | ||
| • Stellate cells | ||
| - Dilated Golgi area (Dvorak et al., 1980b) | ||
| - Increase in the rough ER (Dvorak et al., 1980b) | ||
| • Interstitial cells of Cajal | ||
| - Secondary lysosomes and vacuolization (Wang et al., 2007; Rumessen et al., 2011) | ||
| - Disrupted vacuoles associated with the rough ER and glycogen clumps (Rumessen et al., 2011) | ||
| - Mitochondrial swelling or loss (Wang et al., 2007) | ||
| - Lipid droplets (Wang et al., 2007) | ||
| - Cytoplasmic filament reduction or loss (Wang et al., 2007) | ||
| - Perinuclear damage (Wang et al., 2007) | ||
| Autonomic nervous system | • Nerve trunk enlargement and distortion (Dvorak et al., 1980b) | • Axons |
| • Axons | - Damage (myelin figures, microtubule reduction, and terminal swelling) or necrosis (swollen and empty axons) (Brewer et al., 1990; Dvorak et al., 1993; Rumessen, 1996; Geboes and Collins, 1998; Rumessen et al., 2010) | |
| - Damage (myelin figures, microtubule reduction, terminal swelling, and lipid droplets) or necrosis (swollen, empty axons) (Dvorak et al., 1980b; Dvorak and Silen, 1985; Steinhoff et al., 1988; Brewer et al., 1990; Dvorak et al., 1993; Geboes and Collins, 1998; Wang et al., 2007; Rumessen et al., 2011) | ||
| - Mitochondrial swelling (Dvorak et al., 1980b) | ||
| - Large membrane-bound vacuoles (Dvorak et al., 1980b) | ||
| - Dense core granules (Dvorak et al., 1980a) | ||
| - Neurofibril accumulation (Dvorak et al., 1980b) | ||
| • Synaptic membrane thickening (Dvorak et al., 1980b) | ||
| • Ganglion cell enlargement with an increase in the rough ER (Dvorak et al., 1980b) |