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Letter
Response to: Correspondence on "PICaSSO Histologic Remission Index (PHRI) in ulcerative colitis: development of a novel simplified histological score for monitoring mucosal healing and predicting clinical outcomes and its applicability in an artificial intelligence system" by Wong et al
  1. Marietta Iacucci1,2,
  2. Tommaso Lorenzo Parigi1,3,
  3. Alina Bazarova4,
  4. Subrata Ghosh5,
  5. Vincenzo Villanacci6,
  6. Xianyong Gui7
  1. 1 Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
  2. 2 Department of Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3 Department of Biomedical Sciences, Humanitas University, Milan, Italy
  4. 4 Forschungszentrum Jülich GmbH, Julich, Nordrhein-Westfalen, Germany
  5. 5 College of Medicine and Health, University College Cork APC Microbiome Institute, Cork, Ireland
  6. 6 Institute of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
  7. 7 Department of Pathology, University of Washington School of Medicine, Seattle, Washington, USA
  1. Correspondence to Dr Marietta Iacucci, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; M.Iacucci{at}bham.ac.uk

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We thank the authors of this correspondence for sharing their post hoc analysis of the VARSITY trial data in UC.1 2 Prior to developing the PICaSSO Histologic Remission Index (PHRI),3 we dissected the discrete histological components and analysed their individual relationship with endoscopic features in the same cohort (unpublished data). We found that neutrophil infiltration (active inflammation), particularly that in lamina propria, had the strongest correlation with the endoscopic scores (Pearson’s r=0.64–0.74, Spearman’s ρ=0.60–0.76; p<0.05) as compared with the other histological components. The total neutrophil infiltration in both epithelium and lamina propria had essentially the same correlation strength as the overall active and chronic inflammation. The other histopathological components, including chronic inflammation, basal plasmacytosis, eosinophilia and crypt architectural distortion, were also correlated but to a lesser and variable degree. When comparing differences between patients in Mayo endoscopic score (MES) 1 and 0, the former group had significantly more active inflammation (neutrophilic …

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Footnotes

  • Contributors MI: study conception and design, data acquisition, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content. TLP: analysis and interpretation of data, drafting the manuscript. AB: statistical analysis. SG: study conception and design, data acquisition, analysis and interpretation of data, drafting of the manuscript. VV: analysis and interpretation of data, drafting the manuscript. XG: study conception and design, data acquisition, analysis and interpretation of data, drafting of the manuscript.

  • Funding The NIHR Biomedical Research Centre supports MI at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.