摘要
AIM. Pouchitis develops in ileoanal pouches in up to 50% of patients with ulcerative colitis during the first 10 years after pouch surgery while being rare in patients after proctocolectomy for familial adenomatous polyposis coil （FAP） syndrome. Defensins are major components of the innate immune system and play a significant role in gastrointestinal microbial homeostasis. Pouch defensin and cytokine expression were correlated with states of pouch inflammation to study their role in pouchitis.METHODS： Patients with ulcerative colitis and FAP syndrome were stratified into groups with pouches after surgery, pouches without or with pouchitis. Biopsies from terminal ileum from a healthy intestine or from normal terminal ileum of patients with ulcerative colitis served as controls, mRNA from pouches and controls was analysed for defensin and cytokine expression.RESULTS： Expression of defensins was increased in all pouches immediately after surgery, compared to ileum of controls. Initially, pouches in ulcerative colitis revealed higher defensin expression than FAP pouches. Defensin expression declined in both patient groups and increased again slightly in pouchitis in patients with ulcerative colitis. FAP pouches without pouchitis had strong expression of β-defensin hBD-1, while all other defensins remained at low levels. Cytokine expression in ulcerative colitis pouches was high, while FAP pouches showed moderately elevated cytokines only after surgery.CONCLUSION： Development of pouchitis correlates with decreased defensin expression in ulcerative colitis in addition to high expression of cytokines. The low incidence of pouchitis in FAP pouches correlates with increased expression of hBD-1 β- defensin in association with low cytokine levels.
瞄准：当在在为家庭腺瘤息肉病关口 i (FAP ) 的 proctocolectomy 以后的病人是稀罕的时， Pouchitis 在小袋外科以后在开始的 10 年期间与 ulcerative 在多达 50% 病人在 ileoanal 小袋发展症候群。Defensins 是天生的免疫系统的主要部件并且在胃肠的微生物引起的动态平衡起一个重要作用。小袋 defensin 和 cytokine 表示与小袋发炎的状态被相关在 pouchitis 学习他们的角色。方法：有 ulcerative 和 FAP 症候群的病人在外科以后与小袋被成层进组，小袋没有或与 pouchitis。从从健康的肠或从有 ulcerative 的病人的正常终端回肠的终端回肠的活体检视用作控制。从小袋和控制的 mRNA 为 defensin 和 cytokine 表示被分析。结果：defensins 的表示在外科以后立即在所有小袋被增加，与控制的回肠相比。开始，在 ulcerative 的小袋比 FAP 小袋揭示了更高的 defensin 表示。Defensin 表示在两个耐心的组衰退了并且与 ulcerative 在病人在 pouchitis 稍微再增加了。没有 pouchitis 的 FAP 小袋有 beta-defensin hBD-1 的强壮的表示，当所有另外的 defensins 在底层留下了时。在 ulcerative 小袋的 Cytokine 表示高，当 FAP 小袋仅仅在外科以后显示出中等提高的 cytokines 时。结论：pouchitis 的开发除了 cytokines 的高表示在 ulcerative 与减少的 defensin 表示相关。在 FAP 小袋的 pouchitis 的低发生与低 cytokine 层次联合与 hBD-1 beta-defensin 的增加的表示相关。
基金
Supported by the Deutsche Forschungsgemeinschaft(SFB 617)
in part by a grant of the Finnish Gastroenterological Society.
