Berrebi D, Languepin J, Ferkdadji L, Foussat A, De Lagausie P, Paris R, Emilie D, Mougenot J F, Cezard J P, Navarro J, Peuchmaur M
Service d'Anatomie et de Cytologie Pathologiques and EA 3102, Université Paris VII, Paris, France.
J Pediatr Gastroenterol Nutr. 2003 Sep;37(3):300-8. doi: 10.1097/00005176-200309000-00018.
Cytokines appear to play a significant role in the pathogenesis of inflammatory bowel disease (IBD) with a predominant Th2 pattern in colonic mucosa of patients with ulcerative colitis (UC). Chemokines and their receptors also regulate the migration of Th1 or Th2 lymphocytes to inflammatory tissues during the immune response. Although adult UC is usually confined to the colon, pediatric UC not uncommonly affects the stomach.
The aim of this study was to compare expression of cytokines, chemokine receptors, and homing molecules in the rectal and the histologically characterized gastric mucosa of pediatric patients with UC. SUBJECTS Sixteen patients (11 girls and 5 boys; median age, 9 years) having all the features of UC were included in the study.
Rectal and gastric mucosa obtained from UC cases were immunostained with antibodies against L-selectin, beta 7 integrin, CXCR3, CCR3, and CCR5. IL-4 and IL-12 p40 transcript expression was studied by in situ hybridization.
Chronic gastritis was found in 93.7% of cases and Helicobacter pylori (Hp) was found in 2 (13.3%) cases. In the rectal and gastric mucosa, CXCR3 was found in perivascular lymphocytes and CCR5 in a subset of CXCR3+ cells in the lamina propria. CCR3+ lymphocytes and IL-4-positive cells were always found, but there was no evidence of IL-12 production. Most of the lymphocytes infiltrating the gastric mucosa expressed beta 7 but not CD62L. In contrast, beta 7-positive cells were randomly dispersed in the rectal lamina propria, and the fraction of CD3+beta 7+ was low.
The authors conclude that gastritis is common in pediatric UC. The presence of CCR3+ lymphocytes, IL-4 transcript expression, without IL-12 p40 production in the stomach and in the rectum suggests a Th2 immune response. The presence of CCR3+, CD62L- activated Th2 cells may suggest that these gastric cells are recruited from colorectal primary lesions.
细胞因子似乎在炎症性肠病（IBD）的发病机制中起重要作用，在溃疡性结肠炎（UC）患者的结肠黏膜中呈现以Th2为主的模式。趋化因子及其受体在免疫反应过程中也调节Th1或Th2淋巴细胞向炎症组织的迁移。虽然成人UC通常局限于结肠，但儿童UC常累及胃部。
本研究旨在比较儿童UC患者直肠和经组织学特征化的胃黏膜中细胞因子、趋化因子受体及归巢分子的表达。
16例具有UC所有特征的患者（11例女孩和5例男孩；中位年龄9岁）纳入本研究。
取自UC病例的直肠和胃黏膜用抗L-选择素、β7整合素、CXCR3、CCR3和CCR5抗体进行免疫染色。通过原位杂交研究IL-4和IL-12 p40转录物表达。
93.7%的病例发现慢性胃炎，2例（13.3%）发现幽门螺杆菌（Hp）。在直肠和胃黏膜中，CXCR3见于血管周围淋巴细胞，CCR5见于固有层中一部分CXCR3+细胞。总是能发现CCR3+淋巴细胞和IL-4阳性细胞，但未发现IL-12产生的证据。浸润胃黏膜的大多数淋巴细胞表达β7但不表达CD62L。相反，β7阳性细胞随机分散在直肠固有层，且CD3+β7+的比例较低。
作者得出结论，胃炎在儿童UC中常见。胃和直肠中存在CCR3+淋巴细胞、IL-4转录物表达但无IL-12 p40产生提示Th2免疫反应。CCR3+、CD62L-活化的Th2细胞的存在可能提示这些胃细胞是从结直肠原发性病变募集而来。
