Sher M E, D'Angelo A J, Stein T A, Bailey B, Burns G, Wise L
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York.
Am J Surg. 1995 Jan;169(1):133-6. doi: 10.1016/s0002-9610(99)80121-4.
Increasing evidence points to a pathologic role for cytokines in Crohn's colitis. Levels of cytokines are increased in diseased segments of colon in Crohn's colitis, but no one has studied the concentration of cytokines in clinically and histologically nondiseased segments.
Mucosal biopsies were obtained from 7 patients with active segmental Crohn's colitis and from 7 controls without inflammatory bowel disease. The concentration of Interleukin (IL)-1 beta, IL-2, IL-6, and IL-8 in patients and controls were determined using enzyme linked immunosorbent assay and compared. Histologic sections were also performed to confirm diseased and nondiseased segments of colon.
The concentrations of IL-1 beta, IL-6, and IL-8 were significantly higher in the involved segments of colon (10.3 +/- 4.1, 3.7 +/- 1.0, 34.4 +/- 6.9 picograms [pg] per mg) when compared to controls (1.8 +/- 0.5, 1.1 +/- 0.5, 5.3 +/- 1.0 pg/mg). The concentrations of IL-1 beta, IL-2, and IL-8 (8.5 +/- 2.9, 5.3 +/- 1.2, 26.3 +/- 8.8 pg/mg) in normal appearing segments of colon of patients with Crohn's colitis were also significantly higher than in controls, whose IL-2 level was 2.0 +/- 0.5 pg/mg. IL-1 beta and IL-8 were significantly more concentrated in both the involved and uninvolved colonic segments of patients with Crohn's colitis compared to controls. IL-2 and IL-6 were also more concentrated in Crohn's patients than in controls, but not significantly. The differences in interleukin concentrations between involved and uninvolved segments of colon in patients with segmental Crohn's colitis were not significant.
Although Crohn's colitis is often a segmental disease, concentrations of IL-1 beta and IL-8 are increased throughout the entire colon. These observations reinforce the hypothesis that Crohn's colitis involves the whole colon even when this is not apparent clinically or histologically.
越来越多的证据表明细胞因子在克罗恩病性结肠炎中起病理作用。在克罗恩病性结肠炎患者的病变结肠段中细胞因子水平升高,但尚未有人研究临床和组织学上无病变结肠段中细胞因子的浓度。
从7例活动性节段性克罗恩病性结肠炎患者和7例无炎症性肠病的对照者获取黏膜活检组织。采用酶联免疫吸附测定法测定患者和对照者中白细胞介素(IL)-1β、IL-2、IL-6和IL-8的浓度并进行比较。还进行了组织学切片以确认结肠的病变段和无病变段。
与对照者(1.8±0.5、1.1±0.5、5.3±1.0皮克[pg]/毫克)相比,结肠受累段中IL-1β、IL-6和IL-8的浓度显著更高(10.3±4.1、3.7±1.0、34.4±6.9 pg/毫克)。克罗恩病性结肠炎患者外观正常的结肠段中IL-1β、IL-2和IL-8的浓度(8.5±2.9、5.3±1.2、26.3±8.8 pg/毫克)也显著高于对照者,对照者的IL-2水平为2.0±0.5 pg/毫克。与对照者相比,克罗恩病性结肠炎患者的受累和未受累结肠段中IL-1β和IL-8的浓度均显著更高。IL-2和IL-6在克罗恩病患者中的浓度也高于对照者,但差异不显著。节段性克罗恩病性结肠炎患者结肠受累段和未受累段之间白细胞介素浓度的差异不显著。
尽管克罗恩病性结肠炎通常是节段性疾病,但整个结肠中IL-1β和IL-8的浓度均升高。这些观察结果强化了这样一种假说,即克罗恩病性结肠炎累及整个结肠,即使在临床或组织学上不明显时也是如此。