Dubucquoi S, Janin A, Klein O, Desreumaux P, Quandalle P, Cortot A, Capron M, Colombel J F
Service d'Anatomie et Cytologie Pathologiques, Hôpital Calmette, Centre Hospitalier Régional et Universitaire, Lille, France.
Gut. 1995 Aug;37(2):242-6. doi: 10.1136/gut.37.2.242.
Endoscopic recurrences after radical surgery for Crohn's disease are useful for studying the pathogenesis of initial lesions of Crohn's disease. Factors predisposing to recurrence are poorly understood, but it has been shown that eosinophilic infiltration of the neoileum may occur within a few weeks of resection. The aim of this study was to compare, in nine patients having an ileocolectomy, the infiltration of eosinophils and their activation state in normal and diseased areas of the neoileum, three months after surgery. Tissue eosinophils were studied by histochemical methods and electron microscopy. Mucosal expression of interleukin 5 (IL 5), an important eosinophil activating factor was studied using in situ hybridisation. Sixty per cent of patients had endoscopic recurrence at three months. Eosinophil infiltration was more pronounced in diseased than in endoscopically normal areas and was associated with a high expression of IL 5 mRNA. Ultrastructural analysis showed features of eosinophil activation, but no cytotoxic lesions of surrounding inflammatory or epithelial cells. This study suggests that local synthesis of IL 5 associated with eosinophil activation in the tissues could participate in early mucosal damage in Crohn's disease.
克罗恩病根治性手术后的内镜复发情况，对于研究克罗恩病初始病变的发病机制很有帮助。导致复发的因素目前了解甚少，但已有研究表明，在切除术后几周内，新回肠可能会出现嗜酸性粒细胞浸润。本研究的目的是比较9例行回结肠切除术的患者在术后三个月时，新回肠正常区域和病变区域中嗜酸性粒细胞的浸润情况及其激活状态。采用组织化学方法和电子显微镜对组织中的嗜酸性粒细胞进行研究。运用原位杂交技术研究重要的嗜酸性粒细胞激活因子白细胞介素5（IL-5）的黏膜表达情况。60%的患者在术后三个月出现内镜复发。嗜酸性粒细胞浸润在病变区域比内镜检查正常的区域更明显，且与IL-5 mRNA的高表达相关。超微结构分析显示有嗜酸性粒细胞激活的特征，但周围炎症或上皮细胞无细胞毒性损伤。本研究提示，组织中与嗜酸性粒细胞激活相关的IL-5局部合成可能参与了克罗恩病早期的黏膜损伤。
