7±0.3% with WT B cells, 2.2±0.2% with IL-10−/− B cells, and 2.0±0.3% without B cells, p<0.01).Summary: WT

but not IL-10−/− B cells ameliorate T cell-mediated colitis despite B cell induction of Foxp3+CD4+ cells being IL-10 independent. IL-10-producing B cells may contribute to intestinal homeostasis by suppressing effector T cells directly (by IL-10 secretion) and indirectly (by inducing IL-10-producing Tr-1 cells). “
“Loss of mucosal barrier integrity is postulated to be an important contributor in the pathogenesis of inflammatory bowel diseases (IBD). Barrier dysfunction can be diagnosed and quantified using in vivo confocal endomicroscopy (CEM) but the prognostic significance of this on clinical follow up is not well known. To measure intestinal barrier click here dysfunction using CEM and determine clinical course of IBD as defined by requirement for treatment escalation (TE). TE was defined as commencement of new drug therapy, dose optimization or need for surgical resection. Consecutive IBD subjects and controls were prospectively recruited for CEM (EC-3870FK, Pentax) using incremental boluses of intravenous 10% fluorescein as contrast agent. Blinded assessment of uninflamed terminal ileum was performed. ‘Fluorescein leak’, ‘cell junction enhancement’, ‘cell drop

out’ and the composite confocal Ganetespib leakage score (CLS) were calculated as measures of intestinal mucosal barrier dysfunction. Area under the curve (AUC) of receiver operator characteristic (ROC) analysis was used to define thresholds separating IBD from controls and IBD with and without TE. The primary endpoint was time (in days) to TE from date of CEM measured statistically using Dichloromethane dehalogenase Kruskal-Wallis, Log rank and Chi square analyses. A total of 43 consecutive subjects were recruited (23 CD, 6 UC, 14 controls; group-matched for age and sex) yielding

11,539 images. Prospective median follow up time was 3.6 months. Median CLS for CD, UC and controls were 18.2, 17.6 and 5.3, respectively (P=0.003). During prospective follow up, there were 11 TE for new drug class or drug optimisation (3 5-ASA, 1 steroid, 1 antibiotics, 2 anti-metabolites, 2 biological drugs, 2 clinical trial) and 1 for surgery. At the best ROC threshold of 8.8, CLS differentiated IBD from controls (AUC: 0.817, sens 81.3%, spec 85.7%; OR of IBD 26.0 [95% CI: 4.56-148.18], P=0.00002). CLS helped in predicting TE (AUC: 0.645) at a cut-off of 15.4 (sens 81.8%, spec 47.6%). Eleven of 23 CEM studies (48%) with a CLS >15 subsequently went on to have TE vs. only 1 of 9 (11%) with CLS ≤15 (P=0.083). CLS >15 was not predictive of serious TE (towards surgery or biological agents, P=0.255). Subjects with CLS in the highest tertile had higher rates of TE compared to the lowest tertile (6/11 vs. 2/10) trending towards statistical significance (OR 4.8 [95% CI: 0.68-33.80], P=0.104). Figure 1 shows the divergence of TE events according to CLS >15 or CLS ≤15 (P=0.055).