Leal R F, Coy C S R, Ayrizono M L S, Fagundes J J, Milanski M, Saad M J, Velloso L A, Góes J R N
Department of Internal Medicine Cellular Signalization Laboratory, Universidade Estadual de Campinas UNICAMP, Campinas, São Paulo, Brazil.
Tech Coloproctol. 2008 Mar;12(1):33-8. doi: 10.1007/s10151-008-0395-9. Epub 2008 May 30.
Pouchitis after total rectocolectomy is among the most common complications of patients with ulcerative colitis (UC). However, its frequency is quite rare in patients with familial adenomatous polyposis (FAP). We evaluated the inflammatory and pro-apoptotic activity in endoscopically normal mucosa of the ileal pouch in patients with UC and FAP.
Twenty patients (10 with UC and 10 with FAP) with "J" pouch after total proctocolectomy were studied as were 10 normal controls. Biopsies were obtained from the mucosa of the pouch of UC and FAP patients and from the normal ileum of controls. The expression levels of TNF-alpha, IL-1beta, IL-6, IL-8 and phospho-BAD were determined by immunoblotting. Activated NFkappaB was evaluated by immuno-precipitation and immunoblotting for IkappaB kinase beta.
Patients with UC had higher levels of IL-1beta, IL-6, IL-8 and TNF-alpha than patients with FAP. The level of TNF-alpha was higher in patients with UC than in patients with FAP; both patient groups had TNF-alpha levels higher than controls. Activation of NFkappaB was similar in all three groups. The expression of phospho-BAD was significantly lower in patients with FAP than in patients with UC.
As compared with patients with FAP, patients with UC presented increased levels of some pro-inflammatory cytokines, even in the absence of clinical or endoscopic signs of pouchitis. Patients with FAP presented lower levels of pro-inflammatory proteins and of phospho-BAD. These findings may explain the higher rates of progression to pouchitis in UC patients, which could correlate with mucosal atrophy that occurs in inflamed tissue.
全直肠结肠切除术后的袋炎是溃疡性结肠炎（UC）患者最常见的并发症之一。然而，其在家族性腺瘤性息肉病（FAP）患者中极为罕见。我们评估了UC和FAP患者回肠袋内镜正常黏膜中的炎症和促凋亡活性。
对20例全直肠结肠切除术后有“J”袋的患者（10例UC患者和10例FAP患者）以及10例正常对照者进行了研究。从UC和FAP患者的袋黏膜以及对照者的正常回肠获取活检组织。通过免疫印迹法测定肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和磷酸化BAD的表达水平。通过免疫沉淀和针对IκB激酶β的免疫印迹法评估活化的核因子κB（NFκB）。
UC患者的IL-1β、IL-6、IL-8和TNF-α水平高于FAP患者。UC患者的TNF-α水平高于FAP患者；两组患者的TNF-α水平均高于对照者。三组中NFκB的活化情况相似。FAP患者中磷酸化BAD的表达明显低于UC患者。
与FAP患者相比，UC患者即使在没有袋炎临床或内镜表现的情况下，某些促炎细胞因子水平也会升高。FAP患者的促炎蛋白和磷酸化BAD水平较低。这些发现可能解释了UC患者袋炎进展率较高的原因，这可能与炎症组织中发生的黏膜萎缩有关。
