The following is a summary of “Association of CD4-positive cell infiltration with response to vedolizumab in patients with ulcerative colitis,” published in the November 2023 issue of Gastroenterology by Miyazaki et al.

In ulcerative colitis (UC) treatment, not all patients respond favorably to biological therapies, so predicting treatment efficacy is challenging. Vedolizumab, a monoclonal antibody targeting the α4β7 integrin, interrupts immune cell migration. Limited information exists about histological markers indicative of vedolizumab’s effectiveness.

This retrospective, multicenter study aimed to assess UC patients undergoing vedolizumab treatment. Biopsies of colonic mucosa taken before vedolizumab initiation were analyzed for CD4, CD68, and CD45 expression areas. Comparisons were made between clinical and histological features in patients achieving remission versus those who did not at week 22 of treatment. The findings revealed that heightened CD4+ infiltration correlated significantly with improved vedolizumab response (odds ratio [OR] = 1.44, P = 0.014). Conversely, the concurrent use of corticosteroids and high Mayo scores negatively affected the vedolizumab response (OR = 0.11, P = 0.008 and OR = 0.50, P = 0.009, respectively). This suggests that histological assessment of CD4+ cell infiltration may be valuable in recognizing patients more likely to benefit from vedolizumab therapy.

Understanding the factors influencing vedolizumab response is vital in treating ulcerative colitis. Highlighting the role of CD4+ cell infiltration in predicting treatment efficacy could help refine patient selection for vedolizumab therapy, potentially optimizing treatment outcomes.

Source: nature.com/articles/s41598-023-47618-3