Digestive Diseases and Sciences

, Volume 53, Issue 7, pp 1865–1868

Tumour Necrosis Factor Alpha in Segmental Colitis Associated with Diverticula

  • Enzo Ierardi
  • Gianmichele Meucci
  • Cesare Hassan
  • Angelo Zullo
  • Gianni Imperiali
  • Vincenzo De Francesco
  • Carmine Panella
  • Sergio Morini
  • Giorgio Minoli
Original Paper

Abstract

The pathogenesis of segmental colitis associated with diverticula (SCAD) is unclear, but tumour necrosis factor alpha (TNF-α) has been shown to play a pivotal role in the pathogenesis of inflammatory bowel diseases. The aim of this study was to assess TNF-α levels in patients with SCAD. In a post hoc analysis of a prospective multicenter study, tissue samples from 13 patients diagnosed with SCAD were subjected to histological analyses. The severity of the inflammation was assessed by means of a histological score and histomorphometry (number of inflammatory cells/mm2). Immunohistochemical staining with an antibody against TNF-α was performed on all biopsies and the degree of staining expressed as the percentage of positive stromal cells/1000 counted (TNF-α score). Matched patients with irritable bowel syndrome (IBS) were used as controls. Over-expression of TNF-α was found in all SCAD patients (38.6 ± 10.4%), and it was associated with a high histological score (2.5 ± 0.5) and neutrophil cell count (16.3 ± 3/mm2). These values were distinctly higher than those found in the IBS controls. Our data suggest that TNF-α activity is involved in SCAD pathogenesis, similarly to what occurs in Crohn’s disease and ulcerative colitis.

Keywords

Segmental colitis associated with diverticula TNF-α 

References

  1. 1.
    Hughes LE (1969) Post-mortem survey of diverticular disease of the colon. 1. Diverticulosis and diverticulitis. Gut 10:336–344PubMedCrossRefGoogle Scholar
  2. 2.
    Imperiali G, Meucci G, Alvisi C et al (2000) Segmental colitis associated with diverticula: a prospective study. Am J Gastroenterol 95:1014–1016PubMedCrossRefGoogle Scholar
  3. 3.
    Koutroubakis IE, Antoniou P, Tzardi M et al (2005) The spectrum of segmental colitis associated with diverticulosis. Int J Colorectal Dis 20:28–32PubMedCrossRefGoogle Scholar
  4. 4.
    Gledhill A, Dixon MF (1998) Crohn’s-like reaction in diverticular disease. Gut 42:392–395PubMedCrossRefGoogle Scholar
  5. 5.
    Shepherd NA (1996) Diverticular disease and chronic idiopathic inflammatory bowel disease: associations and masquerades. Gut 38:801–802PubMedCrossRefGoogle Scholar
  6. 6.
    Peppercorn MA (1992) Drug-responsive chronic segmental colitis associated with diverticula: a clinical syndrome in the elderly. Am J Gastroenterol 87:609–612PubMedGoogle Scholar
  7. 7.
    Reimund JM, Wittersheim C, Dumont S et al (1996) Increased production of tumour necrosis factor-alpha interleukin-1 beta, and interleukin-6 by morphologically normal intestinal biopsies from patients with Crohn’s disease. Gut 39:684–689PubMedCrossRefGoogle Scholar
  8. 8.
    Murch SH, Lamkin VA, Savage MO et al (1991) Serum concentrations of tumour necrosis factor a in childhood chronic inflammatory bowel disease. Gut 32:913–917PubMedCrossRefGoogle Scholar
  9. 9.
    Braegger CP, Nicholls S, Murch SH et al (1992) Tumour necrosis factor alpha in stool as a marker of intestinal inflammation. Lancet 339:89–91PubMedCrossRefGoogle Scholar
  10. 10.
    Reinecker H-C, Steffen M, Witthoeft T et al (1993) Enhanced secretion of tumour necrosis factor-alpha, IL-6, and IL-1b by isolated lamina propria mononuclear cells from patients with ulcerative colitis and Crohn’s disease. Clin Exp Immunol 94:174–181PubMedCrossRefGoogle Scholar
  11. 11.
    Plevy SE, Landers CJ, Prehn J et al (1997) A role for TNF-alpha and mucosal T helper-1 cytokines in the pathogenesis of Crohn’s disease. J Immunol 159:6276–6282PubMedGoogle Scholar
  12. 12.
    Berner B, Akca D, Jung T et al (2000) Analysis of Th1 and Th2 cytokines expressing CD4+ and CD8+ T cells in rheumatoid arthritis by flow cytometry. J Rheumatol 27:1128–1135PubMedGoogle Scholar
  13. 13.
    Murch SH, Braegger CP, Walker-Smith JA et al (1993) Location of tumour necrosis factor alpha by immunohistochemistry in chronic inflammatory bowel disease. Gut 34:1705–1709PubMedCrossRefGoogle Scholar
  14. 14.
    Hassan C, Ierardi E, Burattini O et al (2007) tumour necrosis factor alpha down-regulation parallels inflammatory regression in ulcerative colitis patients treated with infliximab. Dig Liver Dis 39:811–817PubMedCrossRefGoogle Scholar
  15. 15.
    Knight DM, Trinh H, Le J et al (1993) Construction and initial characterization of a mouse-human chimeric anti-TNF-antibody. Mol Immunol 30:1443–1453PubMedCrossRefGoogle Scholar
  16. 16.
    Rutgeerts P, Sandborn WJ, Feagan BG et al (2005) Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 353:2462–2476PubMedCrossRefGoogle Scholar
  17. 17.
    Hanauer SB, Feagan BG, Lichtenstein GR et al (2002) Maintenance infliximab for Crohn’s disease: the ACCENT I randomised trial. Lancet 359:1541–1549PubMedCrossRefGoogle Scholar
  18. 18.
    Sands BE, Anderson FH, Bernstein CN et al (2004) Infliximab maintenance therapy for fistulising Crohn’s disease. N Engl J Med 350:876–885PubMedCrossRefGoogle Scholar
  19. 19.
    Baert FJ, D’Haens GR, Peeters M et al (1999) tumour necrosis factor alpha antibody (infliximab) therapy profoundly down-regulates the inflammation in Crohn’s ileocolitis. Gastroenterology 116:22–28PubMedCrossRefGoogle Scholar
  20. 20.
    Hassan C, Zullo A, Ierardi E et al (2006) Tumour necrosis factor alpha downregulation and therapeutic response to infliximab in a case of segmental colitis associated with diverticula. Gut 55:589–590PubMedCrossRefGoogle Scholar
  21. 21.
    Imperiali G, Terpin MM, Meucci G et al (2006) Segmental colitis associated with diverticula: a 7-year follow-up study. Endoscopy 38:610–612PubMedCrossRefGoogle Scholar
  22. 22.
    Morson BC, Dawson IMP (1979) Gastro-intestinal pathology, 2nd edn. Blackwell Scientific Publications, Oxford, pp 530–533Google Scholar
  23. 23.
    Ierardi E, Monno RA, Gentile A et al (2001) Helicobacter heilmannii gastritis: a histological and immunohistochemical trait. J Clin Pathol 54:774–777PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Enzo Ierardi
    • 1
  • Gianmichele Meucci
    • 2
  • Cesare Hassan
    • 3
  • Angelo Zullo
    • 3
  • Gianni Imperiali
    • 2
  • Vincenzo De Francesco
    • 1
  • Carmine Panella
    • 1
  • Sergio Morini
    • 3
  • Giorgio Minoli
    • 2
  1. 1.Section of Gastroenterology, Department of Medical Sciences, University of FoggiaOspedali RiunitiFoggia Italy
  2. 2.Department of Gastroenterology“Valduce” HospitalComoItaly
  3. 3.Gastroenterology and Digestive Endoscopy Unit“Nuovo Regina Margherita” HospitalRomeItaly

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