Journal of Gastrointestinal Surgery

, Volume 11, Issue 1, pp 16–21

Cytokine Network in Chronic Perianal Crohn’s Disease and Indeterminate Colitis After Colectomy

  • Cesare Ruffolo
  • Marco Scarpa
  • Diego Faggian
  • Giovanna Romanato
  • AnnaMaria De Pellegrin
  • Teresa Filosa
  • Daniela Prando
  • Lino Polese
  • Michele Scopelliti
  • Fabio Pilon
  • Elena Ossi
  • Mauro Frego
  • Davide Francesco D’Amico
  • Imerio Angriman
Article

DOI: 10.1007/s11605-006-0021-y

Cite this article as:
Ruffolo, C., Scarpa, M., Faggian, D. et al. J Gastrointest Surg (2007) 11: 16. doi:10.1007/s11605-006-0021-y

Abstract

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.

Keywords

Perianal Crohn’s disease Cytokines Indeterminate colitis 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Cesare Ruffolo
    • 1
  • Marco Scarpa
    • 1
  • Diego Faggian
    • 2
  • Giovanna Romanato
    • 3
  • AnnaMaria De Pellegrin
    • 3
  • Teresa Filosa
    • 1
  • Daniela Prando
    • 1
  • Lino Polese
    • 1
  • Michele Scopelliti
    • 1
  • Fabio Pilon
    • 1
  • Elena Ossi
    • 3
  • Mauro Frego
    • 1
  • Davide Francesco D’Amico
    • 1
  • Imerio Angriman
    • 1
  1. 1.Clinica Chirurgica 1^, Department of Surgical and Gastroenterological SciencesUniversity of PaduaPadovaItaly
  2. 2.Medicina di LaboratorioUniversity of PaduaPadovaItaly
  3. 3.Department of Medical and Surgical SciencesUniversity of PaduaPadovaItaly