Tissue-based predictive biomarkers

Aart Mookhoek, H-ECCO Committee Chair

Aart Mookhoek

The last decade has seen a dramatic increase in drugs available for the treatment of IBD. However, each of these novel biologics or small molecules achieves disease remission in only a relatively small proportion of patients [1].To date, implementation in clinical practice of evidence that assists in better evaluating the chance of therapy success in a particular patient for a particular drug is limited. Therefore, when choosing a drug for a patient with IBD who is starting therapy or needs to switch drugs, a trial-and-error approach may be unavoidable.

To address this unmet clinical need, several research groups have now turned their attention to biomarker discovery to allow development of an evidence-based personalised treatment strategy [2]. At this year’s Congress of ECCO in Stockholm, I had the opportunity to provide an update on the field of biomarker discovery from the perspective of a pathologist. In this issue of ECCO News, I want  to share with you the most important points from that H-ECCO Masterclass talk.

Posted in ECCO News, Committee News, Volume 19, Issue 2, H-ECCO


Report on the 9th H-ECCO IBD Masterclass

Ann Driessen, ECCO Member

Ann Driessen

The theme of the 19th ECCO Congress in Stockholm, “Crossing borders in IBD”, was reflected in the aim of our educational meeting, which extended beyond the histopathological aspects of IBD. The objective was to highlight the collaboration between different specialisations, mirroring the multidisciplinary nature of our daily practice.  This was clearly evident in the various topics covered during our initial session. Additionally, the Congress theme resonated in the diverse composition of our audience. Feedback revealed an equal division between pathologists and specialists from other fields. 

Posted in ECCO News, Committee News, Volume 19, Issue 1, H-ECCO


Fibrosis IBD

Roger Feakins, H-ECCO Member

Roger Feakins

Fibrosis and other connective tissue abnormalities are common in IBD, especially in Crohn’s Disease. The main clinical consequence is strictures, occurring most often in the small bowel or at the ileocaecal/ileocolic junction. Surgery may be necessary for stricture management.

Posted in ECCO News, Committee News, Volume 18, Issue 4, H-ECCO


Histopathological features of Very Early Onset Inflammatory Bowel Disease

Pamela Baldin, H-ECCO Member

Pamela Baldin

Very Early Onset Inflammatory Bowel Disease (VEO-IBD) is a complex subset of IBD that uniquely affects children under six years of age [1]. This category includes neonatal onset (within the first month of life), infantile onset (before two years) and early childhood onset (between two and six years) [2]. In comparison with patients with older onset IBD, those with VEO-IBD demonstrate a more heterogeneous phenotype and the aetiology is more closely related (in approximately 25%–30% of cases) to monogenic or digenic defects involving genes associated with primary immunodeficiency [3]. Moreover, VEO-IBD patients show higher rates of positive family history, a more aggressive clinical trajectory and increased resistance to conventional therapies effective in managing IBD among older patients [4].

Posted in ECCO News, Committee News, Volume 18, Issue 3, H-ECCO


Artificial Intelligence: A Future Tool in the Pathologist’s Toolbox

Aart Mookhoek, H-ECCO Member

Aart Mookhoek

At the 18th Congress of ECCO in Copenhagen in 2023, many exciting projects on artificial intelligence (AI) were presented. Most of these projects focused on the role of AI in endoscopy. As a pathologist, I asked myself the following question: What about the role of AI in the histological evaluation of IBD?

The pathologist plays an important role in establishing the diagnosis and in assessing therapy response. Given that in many parts of the world IBD prevalence is still rising and histological remission may soon become a treatment target, the workload for pathologists is expected to increase. Therefore, as it promises to guide and thereby reduce time spent on biopsy assessment, AI is an interesting tool for pathologists. Moreover, it may aid the mission of H-ECCO to “raise standards of IBD pathology reporting” by mitigating problems associated with inter-observer variability.

Posted in ECCO News, Committee News, Volume 18, Issue 2, H-ECCO


Report on the 8th H-ECCO IBD Masterclass at ECCO’23

Ann Driessen, H-ECCO Chair

Ann Driessen

After two years of virtual meetings, the main goal of the 18th ECCO Congress, held in Copenhagen (March 1–4, 2023), was “Let’s get physical”. During this conference we enjoyed the face-to-face interaction, which provided a positive boost to the 8th H-ECCO Masterclass. The aim of our meeting was not only to discuss the histopathological aspects of Inflammatory Bowel Disease but also to demonstrate the interaction between the different specialisms, which reflects the multidisciplinary collaboration in our daily practice.

Posted in ECCO News, Committee News, ECCO'23, Volume 18, Issue 1, H-ECCO


My experience as H-ECCO Committee Chair

Gert de Hertogh, H-ECCO Chair

Gert de Hertogh

The 15th Congress of ECCO was held in Vienna, Austria between February 12 and 15, 2020. During this meeting, it was decided that I would take over from Roger Feakins as second Chair of the H(istology)-ECCO Committee. The committee was at that time one of the most recently established. Its primary aim is to expand the knowledge of IBD histopathology by organising a yearly masterclass. However, the framework of ECCO also offers many other opportunities to support clinical decision-making, by linking with the other committees and by participation in the composition of ECCO Practice Guidelines, Position Statements and Topical Reviews.

Posted in ECCO News, Committee News, Volume 17, Issue 4, H-ECCO


New Developments to Standardise the Assessment of Mucosal Histology in Crohn’s Disease

Gert de Hertogh, H-ECCO Chair

Gert de Hertogh

The past 6 months of 2022 have seen the publication of two important papers, one by F. Magro et al. (“The ECCO position on harmonisation of Crohn’s disease mucosal histopathology” [1]) and the other by I.O. Gordon et al. (“International consensus to standardise histopathological scoring for small bowel strictures in Crohn’s disease” [2]).

Posted in ECCO News, Committee News, H-ECCO, Volume 17, Issue 3


New H-ECCO Member

Gert de Hertogh, H-ECCO Chair

Gert de Hertogh

The H-ECCO Committee is saying goodbye to Monika Tripathi and would like to thank her for all her work on behalf of the Committee in recent years.

At the same time, as chairman of the Committee, I am very happy to welcome our new member, Aart Mookhoek. Aart currently works as a pathologist at the Institute of Pathology, University of Bern, Switzerland. He is, however, Dutch originally, and developed his passion for gastrointestinal pathology during a residency and subsequent fellowship at the University of Amsterdam, the Netherlands. Aart and I trained together on histological scoring systems for disease activity in Ulcerative Colitis and Crohn’s Disease, and we participated in a research project on this topic.

Posted in ECCO News, Committee News, H-ECCO, Volume 17, Issue 2


Report on the 7th H-ECCO IBD Masterclass at ECCO’22

Gert De Hertogh, H-ECCO Chair

Gert De Hertogh

Contrary to everyone’s ardent expectations and hopes, this year’s ECCO Congress was once again held virtually. While the experiences from 2021 had taught the H-ECCO Committee how to prepare for this and what to expect, we were so happy to be supported again by an excellent ECCO Office team.

Posted in ECCO News, Committee News, ECCO'22, H-ECCO, Volume 17, Issue 1