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Association of CD4-positive cell infiltration with response to vedolizumab in patients with ulcerative colitis

Miyazaki, Haruka Hoshi, Namiko Ishida, Tsukasa Nishioka, Chiharu Ouchi, Sachiko Shirasaka, Daisuke Yoshie, Tomoo Munetomo, Yoshinori Sakamoto, Yoshio Osuga, Tatsuya Matsui, Saori Hyodo, Toshiki Denda, Tamami Watanabe, Daisuke Ooi, Makoto Kodama, Yuzo 神戸大学

2023.11.20

概要

Not all patients with ulcerative colitis (UC) respond initially to treatment with biologic agents, and predicting their efficacy prior to treatment is difficult. Vedolizumab, a humanized monoclonal antibody against alpha 4 beta 7 (α4β7) integrin, suppresses immune cell migration by blocking the interaction between α4β7 integrin and mucosal addressin cell adhesion molecule 1. Reports about histological features that predict vedolizumab efficacy are scarce. So, we examined the association between histological features and vedolizumab efficacy. This was a multicenter, retrospective study of patients with UC treated with vedolizumab. Biopsy specimens taken from the colonic mucosa prior to vedolizumab induction were used, and the areas positively stained for CD4, CD68, and CD45 were calculated. Clinical and histological features were compared between those with and without remission at week 22, and the factors associated with clinical outcomes were identified. We enrolled 42 patients. Patients with a high CD4+ infiltration showed a better response to vedolizumab [odds ratio (OR) = 1.44, P = 0.014]. The concomitant use of corticosteroids and high Mayo scores had a negative association with the vedolizumab response (OR = 0.11, P = 0.008 and OR = 0.50, P = 0.009, respectively). Histological evaluation for CD4+ cell infiltration may be helpful in selecting patients who can benefit from vedolizumab.

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Acknowledgements

We thank the members of the Kobe IBD Study Group for their efforts in patient enrollment. The members of the

Kobe IBD Study Group not included as authors are as follows: Junya Ando (Ando Gastroenterology IBD Clinic),

Michitaka Kohashi (Kakogawa Central City Hospital), Mari Noda (Osaka Saiseikai Nakatsu Hospital), Hidenori

Tanaka (Sanda City Hospital). We would like to thank Editage for English language editing.

Author contributions

All authors contributed to the study conception and design. The material preparation, data collection and analysis

were performed by H.M. and N.H. The first draft of the manuscript was written by H.M., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Competing interests The authors declare no competing interests.

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