Utilization of NBi in assessing Luminal INflammaion in IBD (UNBLIND)

  • Research type

    Research Study

  • Full title

    Utility of narrow band endoscopy in predicting short and long term risk of relapse in patients with quiescent ulcerative colitis.

  • IRAS ID

    120491

  • Contact name

    Venkataraman Subramanian

  • Contact email

    venkat.subramanian@leedsth.nhs.uk

  • Sponsor organisation

    Leeds teaching Hospitals NHS Trust

  • Research summary

    Ulcerative colitis (UC) is a chronic inflammatory condition of unknown aetiology, characterized by a diffuse confluent mucosal inflammation of the colon starting from the rectum with a relapsing and remitting course. Conventional endoscopy was thought to be a reliable parameter of disease activity, but microscopic inflammation can persist despite normal mucosal findings. Histologically detectable inflammation is associated with a greater risk of subsequent relapse. A flare in UC activity is difficult to predict, but a simple, easily measured biological marker of relapse would be important in guiding the most appropriate therapy.
    Recent technological advances in fiber optics, light sources, detectors, and molecular biology have stimulated development of numerous optical methods that promise to significantly improve our ability to evaluate human epithelium in vivo. These methods, collectively termed “optical biopsy,” are non-destructive in situ assays of mucosal histopathology using light that can provide instantaneous tissue assessment. Narrow band imaging (NBI) is a novel technique that enhances the diagnostic capability of endoscopes in characterising tissues by using filters in a red-green-blue (RGB) sequential illumination system. This results in improved mucosal contrast and detail.
    UC always involves the distal colon and activity is usually greatest in recto-sigmoid area. This makes evaluation of the rectum and sigmoid an attractive marker in patients with UC. Unlike serum and faecal markers, endoscopic assessment of the mucosa is unlikely to be affected by systemic disease and would be acceptable test for patients and physicians.
    We plan to evaluate THE recto-sigmoid mucosa in patients with UC by flexible endoscope using both white light and NBI endoscopy. These patients will be followed by for one year or until they relapse, whichever comes first. The aim of our study is to develop endoscopic biomarkers to predict relapse in acute and quiescent UC.

  • REC name

    Yorkshire & The Humber - South Yorkshire Research Ethics Committee

  • REC reference

    13/YH/0115

  • Date of REC Opinion

    20 Jun 2013

  • REC opinion

    Further Information Favourable Opinion