Cytokine Network in Chronic Perianal Crohn’s Disease and Indeterminate Colitis After Colectomy
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Antitumor necrosis factor alpha (anti-TNF-α) therapy in perianal Crohn’s disease (CD) is widely established but recent studies suggest that the underlying fistula tract and inflammation may persist. Treatment with a monoclonal antibody against interleukin (IL)-12 was reported to induce clinical responses and remissions in patients with active CD. The aim of our study was to analyze the cytokine network (TNF-α, IL-12, IL-1β, and IL-6) in 12 patients with chronic perianal CD and a Crohn’s disease activity index (CDAI) score <150 to exclude active intestinal disease, in 7 patients with indeterminate colitis (IC) after restorative proctocolectomy with perianal complications, in 7 patients with active intestinal CD without perianal manifestations, and in 19 healthy controls. Nonparametric Mann–Whitney U test and Spearman’s rank correlation test were used. Serum TNF-α levels were significantly higher in patients with IC than perianal CD patients and healthy controls. Serum TNF-α levels significantly correlated with perianal CDAI score and with the presence of anal fistulas. Serum IL-12 levels correlated with the presence of anal strictures and were similar in all groups. Serum IL-6 levels were significantly higher in the presence of perianal fistulas and lower in the presence of anal strictures. Our study confirmed that TNF-α plays a major role in the perianal and intestinal CD. Furthermore, the significantly higher TNF-α serum levels in patients with IC suggest the use of anti-TNF-α in such patients. On the contrary, according to our results the efficacy of anti-IL-12 antibodies appears doubtful in chronic perianal CD or IC without anal strictures. The role of IL-6 as a systemic mediator for active chronic inflammation was confirmed and a possible role for its monoclonal antibody was suggested.
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- Cytokine Network in Chronic Perianal Crohn’s Disease and Indeterminate Colitis After Colectomy
Journal of Gastrointestinal Surgery
Volume 11, Issue 1 , pp 16-21
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Perianal Crohn’s disease
- Indeterminate colitis
- Industry Sectors
- Author Affiliations
- 1. Clinica Chirurgica 1^, Department of Surgical and Gastroenterological Sciences, University of Padua, Via Giustiniani, 2, Padova, 35100, Italy
- 2. Medicina di Laboratorio, University of Padua, Padova, Italy
- 3. Department of Medical and Surgical Sciences, University of Padua, Padova, Italy