Crypt production in normal and diseased human colonic epithelium.

New crypts are added continuously to the adult mouse intestinal epithelium by a process of crypt replication. Branching crypts found in the epithelium represent a stage in the process of crypt replication. In "normal" human colonic epithelium we found a small but definite percentage of branching crypts, 0.44 +/- 0.16, indicating that new crypts are being produced at a low rate in this epithelium. Significantly higher (P less than .001) percentages of branching crypts, 30.4 +/- 5.75, 15.1 +/- 1.08, and 13.2 +/- 1.05, were found in diseased colonic epithelium from patients with ulcerative colitis, Crohn's disease, and multiple polyposis, respectively. These results may be interpreted as suggesting that the rate of crypt production in human colonic epithelium is increased in a number of disease states. We concluded that, as in the mouse intestinal epithelium, the rate of the crypt replication process in human colonic epithelium is plastic and may respond to a variety of conditions.