Cioffi Ugo, Ciulla Michele M, De Simone Matilde, Paliotti Roberta, Pierini Alberto, Magrini Fabio, Botti Fiorenzo, Contessini-Avesani Ettore
Department of Surgery, University of Milan, Ospedale Maggiore di Milano-IRCCS, Via F Sforza, 35-20122, Milano, Italy.
BMC Public Health. 2002 Sep 10;2:19. doi: 10.1186/1471-2458-2-19.
Experimental evidences suggest an increased collagen deposition in inflammatory bowel diseases (IBD). In particular, large amounts of collagen type I, III and V have been described and correlated to the development of intestinal fibrotic lesions. No information has been available until now about the possible increased collagen deposition far from the main target organ. In the hypothesis that chronic inflammation and increased collagen metabolism are reflected also in the systemic circulation, we aimed this study to evaluate the effects on left ventricular wall structure by assessing splancnic and systemic collagen metabolism (procollagen III assay), deposition (ultrasonic tissue characterization), and cardiac function (echocardiography) in patients with different long standing history of IBD, before and after surgery.
Thirty patients affected by active IBD, 15 with Crohn and 15 with Ulcerative Colitis, submitted to surgery will be enrolled in the study in a double blind fashion. They will be studied before the surgical operation and 6, 12 months after surgery. A control group of 15 healthy age and gender-matched subjects will also be studied. At each interval blood samples will be collected in order to assess the collagen metabolism; a transthoracic echocardiogram will be recorded for the subsequent determination of cardiac function and collagen deposition.
From this study protocol we expect additional information about the association between IBD and cardiovascular disorders; in particular to address the question if chronic inflammation, through the altered collagen metabolism, could affect left ventricular structure and function in a manner directly related to the estimated duration of the disease.
实验证据表明炎症性肠病（IBD）中胶原蛋白沉积增加。特别是，已描述了大量的I型、III型和V型胶原蛋白，并将其与肠道纤维化病变的发展相关联。到目前为止，关于远离主要靶器官的胶原蛋白沉积可能增加的情况尚无相关信息。基于慢性炎症和胶原蛋白代谢增加也反映在体循环中的假设，我们开展本研究，旨在通过评估不同病程的IBD患者手术前后的内脏和全身胶原蛋白代谢（前胶原III测定）、沉积（超声组织特征分析）及心脏功能（超声心动图），来评价其对左心室壁结构的影响。
30例患有活动性IBD的患者（15例克罗恩病患者和15例溃疡性结肠炎患者）将接受手术，并以双盲方式纳入本研究。在手术前以及术后6个月和12个月对他们进行研究。还将对15名年龄和性别匹配的健康受试者组成的对照组进行研究。在每个时间点采集血样以评估胶原蛋白代谢；记录经胸超声心动图，随后测定心脏功能和胶原蛋白沉积情况。
通过本研究方案，我们期望获得有关IBD与心血管疾病之间关联的更多信息；特别是解决慢性炎症是否通过改变胶原蛋白代谢，以与疾病估计病程直接相关的方式影响左心室结构和功能这一问题。
