Evaluation of Ulcerative Colitis Patients with High Neutrophilic Infiltration in the Colonic Mucosa Epithelium

Aim: Interleukin (IL)-23 exerts its effects by activating Th17 cells, which lead to neutrophil activation. The Geboes score Grade 3 focuses on the presence of neutrophil infiltration in the colonic mucosal epithelium of ulcerative colitis (UC). We developed a reproducible method based on the definition of Geboes score Grade 3 and determined the proportion of patients classified as Grade 3.
Method: This was a prospective study conducted at our Hospital between January and December 2024. The Mayo Endoscopic Subscore (MES) and the Geboes scores were used. For evaluation of Geboes score Grade 3, the total number of crypts in the slide was counted, followed by the number of crypts with neutrophil infiltration. The percentage of crypts with neutrophil infiltration was calculated, and the Geboes score Grade 3 was graded from 3.0 to 3.3.
Results: A total of 29 patients diagnosed with UC were included. 20 (69%) were male, and the median age was 46 years. Six (21%) were classified as Grade 3.0, seven (24%) as Grade 3.1, and 16 (55%) as Grade 3.2. Twelve (75%) of the 16 were MES 2.
Conclusions: We found 60% of patients were classified as Grade 3.2. This method may help identify patients who are likely to respond effectively to IL-23 antagonists.