Gastroenterology Service, ASL BAT, Andria, BT, Italy.
J Gastrointestin Liver Dis. 2011 Dec;20(4):365-70.
Tumour necrosis factor-α (TNF-α) expression may be increased in segmental colitis associated with diverticulosis (SCAD). Our aim was to assess TNF-α expression in SCAD in relationship to the treatment.
10 patients affected by severe (type B and D) SCAD were studied (6 males, 4 females, mean age 60.54 years, range 43-85 years). All patients were treated with beclomethasone dipropionate 10 mg/day plus a probiotic preparation VSL#3 for 8 weeks. At that time, clinical, endoscopic and histological reassessment was performed. Controls were 5 patients with active ulcerative colitis (UC).
After treatment, all SCAD B and no SCAD D patients were in remission. The TNF-α expression dropped from 42.7% (+/-7.58) to 15.7% (+/-2.6) in SCAD B patients (p=0.001), and from 40% (+/-5.9) to 28.6% (+/-5.3) in SCAD D patients (p=0.005). In UC patients, the TNF-α expression dropped from 45.5% (+/-5.09) to 22.5% (+/-2.5) (p=0.001). Neither SCAD B nor SCAD D patients showed a significant difference in TNF-α expression compared to UC after treatment. Finally, TNF-α was significantly overexpressed in SCAD D than in SCAD B at the end of treatment (p=0.048).
TNF-α expression in SCAD down regulates after treatment, and seems to be related to the clinical response to therapy. This behaviour, similar to that of Inflammatory Bowel Diseases (IBD), confirms that this disease should be considered as a subtype of IBD.
肿瘤坏死因子-α（TNF-α）的表达可能在与憩室病相关的节段性结肠炎（SCAD）中增加。我们的目的是评估 SCAD 中 TNF-α的表达与治疗的关系。
研究了 10 例严重（B 型和 D 型）SCAD 患者（6 名男性，4 名女性，平均年龄 60.54 岁，范围 43-85 岁）。所有患者均接受丙酸倍氯米松 10mg/天加益生菌制剂 VSL#3 治疗 8 周。当时，进行了临床、内镜和组织学重新评估。对照组为 5 例活动期溃疡性结肠炎（UC）患者。
治疗后，所有 SCAD B 型患者和无 SCAD D 型患者均缓解。SCAD B 型患者的 TNF-α表达从 42.7%（+/-7.58）降至 15.7%（+/-2.6）（p=0.001），SCAD D 型患者从 40%（+/-5.9）降至 28.6%（+/-5.3）（p=0.005）。UC 患者的 TNF-α表达从 45.5%（+/-5.09）降至 22.5%（+/-2.5）（p=0.001）。治疗后，与 UC 相比，SCAD B 型和 SCAD D 型患者的 TNF-α表达均无显著差异。最后，治疗结束时 SCAD D 型患者的 TNF-α表达明显高于 SCAD B 型（p=0.048）。
SCAD 中的 TNF-α表达在治疗后下调，并且似乎与对治疗的临床反应有关。这种行为类似于炎症性肠病（IBD），证实这种疾病应被视为 IBD 的一种亚型。
