Defensin expression in chronic pouchitis in patients with ulcerative colitis or familial adenomatous polyposis coli

• Published in: World journal of gastroenterology : WJG 2006-02, Vol.12 (7), p.1056-1062
• Main Authors: Kiehne, Karlheinz, Brunke, Gabriele, Wegner, Franziska, Banasiewicz, Tomas, Folsch, Ulrich R, Herzig, Karl-Heinz
• Format: Article
• Language: English
• Subjects: Adenomatous Polyposis Coli - genetics; Adenomatous Polyposis Coli - metabolism; Adenomatous Polyposis Coli - pathology; Adolescent; Adult; alpha-Defensins - biosynthesis; alpha-Defensins - genetics; beta-Defensins - biosynthesis; beta-Defensins - genetics; Chronic Disease; Colitis, Ulcerative - genetics; Colitis, Ulcerative - metabolism; Colitis, Ulcerative - pathology; Colonic Pouches - pathology; Cytokines - biosynthesis; Cytokines - genetics; Defensins - biosynthesis; Defensins - genetics; Female; Gene Expression Regulation; Homeostasis; Humans; Ileum - cytology; Ileum - metabolism; Ileum - pathology; Immune System - physiology; Intestinal Mucosa - cytology; Intestinal Mucosa - metabolism; Intestinal Mucosa - pathology; Male; Middle Aged; Pouchitis - genetics; Pouchitis - metabolism; Pouchitis - pathology; Proctocolectomy, Restorative; RNA, Messenger - genetics; RNA, Messenger - metabolism; 基因表达; 息肉疾病; 慢性肠溃疡; 细胞活素类
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v12.i7.1056

AIM. Pouchitis develops in ileoanal pouches in up to 50% of patients with ulcerative colitis during the first 10 years after pouch surgery while being rare in patients after proctocolectomy for familial adenomatous polyposis coil （FAP） syndrome. Defensins are major components of the innate immune system and play a significant role in gastrointestinal microbial homeostasis. Pouch defensin and cytokine expression were correlated with states of pouch inflammation to study their role in pouchitis. METHODS： Patients with ulcerative colitis and FAP syndrome were stratified into groups with pouches after surgery, pouches without or with pouchitis. Biopsies from terminal ileum from a healthy intestine or from normal terminal ileum of patients with ulcerative colitis served as controls, mRNA from pouches and controls was analysed for defensin and cytokine expression. RESULTS： Expression of defensins was increased in all pouches immediately after surgery, compared to ileum of controls. Initially, pouches in ulcerative colitis revealed higher defensin expression than FAP pouches. Defensin expression declined in both patient groups and increased again slightly in pouchitis in patients with ulcerative colitis. FAP pouches without pouchitis had strong expression of β-defensin hBD-1, while all other defensins remained at low levels. Cytokine expression in ulcerative colitis pouches was high, while FAP pouches showed moderately elevated cytokines only after surgery. CONCLUSION： Development of pouchitis correlates with decreased defensin expression in ulcerative colitis in addition to high expression of cytokines. The low incidence of pouchitis in FAP pouches correlates with increased expression of hBD-1 β- defensin in association with low cytokine levels.