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Mononuclear cells in peripheral venous blood of patients with Crohn's disease: preoperative status and postoperative course, influence of duration, activity and extent of disease

Mononukleäre Zellen des peripheren Venenblutes von Patienten mti Morbus Crohn: präoperativer Status und postoperativer Verlauf, Einfluß von Dauer, Aktivität und Ausdehnung der Erkrankung

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Zusammenfassung

Systemische immunologische Veränderungen bei Morbus Crohn sind wahrscheinlich durch die intestinale Entzündung verursacht. So könnte es sein, daß Veränderungen unter den mononuklären Zellen des peripheren Venenblutes ein diagnostisch relevanter Indikator der intestinalen Krankheitsaktivität sind. Zur Überprüfung dieser Hypothese wurden von 151 chirurgischen Crohn-Patienten CD3+, CD4+, CD8+, B Zellen, Makrophagen, Leukozyten und die relative Lymphozytenzahl im Vergleich zu einem Kontrollkollektiv präoperativ analysiert. Bei einem Teil der Patienten wurde die Analyse 10 Tage, 3 Monate und 6 Monate postoperativ wiederholt. Die präoperativen Blutzelldaten wurden mit Anamnesedauer, Ausdehnung und Lokalisation der Erkrankung, Medikation und dem CDAI nach Best korreliert. Gesamtleukozytenzahl, Makrophagen, CD8+ und B Zellen waren bei Crohn-Patienten präoperativ signifikant erhöht. Hingegen zeigten CD3+, CD4+ Zellen und die relative Lymphozytenzahl eine signifikante Erniedrigung. Sechs Monate postoperativ persistierten eine erhöhte Makrophagen- und Leukozytenzahl sowie eine Erniedrigung der CD4+ Zellen als einzige pathologische Veränderungen. Die präoperativen Blutzelldaten korrelierten mit keinem der untersuchten klinischen Eckdaten der Crohn-Erkrankung. Die Analyse von mononukleä-ren Zellen des peripheren Venenblutes ist somit für klinisch-diagnostische Fragestellungen von untergeordneter Bedeutung. Der postoperative Fortbestand einiger Veränderungen dieser Zellpopulationen ist dennoch ein wichtiger Hinweis auf die enge Verbindung zwischen peripherem Venenblut und intestinaler Läsion.

Summary

In Crohn's disease (CD) the intestinal lesion is supposed to be the cause of the observed systemic immunologic changes. Based on this assumption, peripheral blood mononuclear cells (PBMC) are of specific interest as a possible indicator of intestinal activity of the disease. From 151 surgical patients CD3+, CD4+, CD8+, B cells, macrophages, leucocytes and the relative number of lymphocytes were analysed preoperatively and 10 days, 3 and 6 months postoperatively. The cell data were correlated with the main clinical data of disease. There was a highly significant preoperative increase of leucocytes, macrophages, CD8+, and B cells in the CD group, and a marked decrease of CD3+, CD4+ cells, and the relative lymphocyte count in the same group. Six months postoperatively, highly elevated macrophages, and leucocytes, and a depressed number of CD4+ cells were the only changes. The preoperative cell data did not correlate with the duration of illness, CDAI, localisation, and extent of the intestinal lesion nor did they correlate with any modality of preoperative drug treatment. Thus, the determination of PBMC characteristics in CD is only of limited value for routine diagnostic purposes. However, the persistence of some pathological values long after operation might be caused by residual microscopic lesions and thus reflect the intestinal process.

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Authors and Affiliations

  1. Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, W-6900, Heidelberg, Bundesrepublik Deutschland

    G. Schürmann, M. Betzler, B. von Ditfurth, U. Abel & C. Herfarth

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  1. G. Schürmann
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  2. M. Betzler
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  3. B. von Ditfurth
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  4. U. Abel
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  5. C. Herfarth
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Schürmann, G., Betzler, M., von Ditfurth, B. et al. Mononuclear cells in peripheral venous blood of patients with Crohn's disease: preoperative status and postoperative course, influence of duration, activity and extent of disease. Langenbecks Arch Chir 376, 27–31 (1991). https://doi.org/10.1007/BF00205124

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  • DOI: https://doi.org/10.1007/BF00205124

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