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Endoscopic finding of spontaneous hemorrhage correlates with tumor necrosis factor alpha expression in colonic mucosa of patients with ulcerative colitis.

Abstract：

BACKGROUND:Ulcerative colitis (UC) is an intractable colonic disease, and it shows several endoscopic findings. Recently, it was reported that the expression level of mucosal tumor necrosis factor alpha (TNF-α) was useful for predicting patient response to infliximab. However, no data regarding the value of endoscopic findings to predict treatment efficacy or cytokine expression level exist. OBJECTIVE:We investigated the expression of leukocyte adhesion-related molecules and cytokines in colonic mucosa and compared it to endoscopic findings. METHODS:One hundred and fifty-nine patients were enrolled. Tissue samples were obtained by colonic biopsy from patients with UC. Colitis activity was determined by Matts' criteria. The degree of mRNA expression of TNF-α, interferon gamma (IFN-γ), interleukin (IL)-8, IL-17A, and mucosal vascular addressin adhesion molecule-1 (MAdCAM-1) in mucosal samples was determined by real-time quantitative polymerase chain reaction. These expression levels were compared with the degree of Matts' grade and individual endoscopic findings. RESULTS:The expression of TNF-α, IFN-γ, IL-8, IL-17A, and MAdCAM-1 mRNA significantly increased as Matts' endoscopic grade elevated. Actively inflamed mucosa with spontaneous hemorrhage revealed a significantly increased expression level of TNF-α mRNA than that without spontaneous hemorrhage. No other individual endoscopic parameter was significantly correlated with the expression level of TNF-α mRNA. CONCLUSIONS:Inflamed mucosa with spontaneous hemorrhage may suggest increased expression of TNF-α mRNA levels in colonic mucosa of UC patients, which could predict a lower response to infliximab treatment and more aggressive induction regime or change to other therapy should be taken into account.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Hozumi H,Hokari R,Kurihara C,Narimatsu K,Sato H,Sato S,Ueda T,Higashiyama M,Okada Y,Watanabe C,Komoto S,Tomita K,Kawaguchi A,Nagao S,Miura S

doi

10.1007/s00384-013-1654-4

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

1049-55

issue

eissn

0179-1958

issn

1432-1262

journal_volume

pub_type

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Endoscopic finding of spontaneous hemorrhage correlates with tumor necrosis factor alpha expression in colonic mucosa of patients with ulcerative colitis.