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Endoscopic finding of spontaneous hemorrhage correlates with tumor necrosis factor alpha expression in colonic mucosa of patients with ulcerative colitis

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Abstract

Background

Ulcerative colitis (UC) is an intractable colonic disease, and it shows several endoscopic findings. Recently, it was reported that the expression level of mucosal tumor necrosis factor alpha (TNF-α) was useful for predicting patient response to infliximab. However, no data regarding the value of endoscopic findings to predict treatment efficacy or cytokine expression level exist.

Objective

We investigated the expression of leukocyte adhesion-related molecules and cytokines in colonic mucosa and compared it to endoscopic findings.

Methods

One hundred and fifty-nine patients were enrolled. Tissue samples were obtained by colonic biopsy from patients with UC. Colitis activity was determined by Matts’ criteria. The degree of mRNA expression of TNF-α, interferon gamma (IFN-γ), interleukin (IL)-8, IL-17A, and mucosal vascular addressin adhesion molecule-1 (MAdCAM-1) in mucosal samples was determined by real-time quantitative polymerase chain reaction. These expression levels were compared with the degree of Matts’ grade and individual endoscopic findings.

Results

The expression of TNF-α, IFN-γ, IL-8, IL-17A, and MAdCAM-1 mRNA significantly increased as Matts’ endoscopic grade elevated. Actively inflamed mucosa with spontaneous hemorrhage revealed a significantly increased expression level of TNF-α mRNA than that without spontaneous hemorrhage. No other individual endoscopic parameter was significantly correlated with the expression level of TNF-α mRNA.

Conclusions

Inflamed mucosa with spontaneous hemorrhage may suggest increased expression of TNF-α mRNA levels in colonic mucosa of UC patients, which could predict a lower response to infliximab treatment and more aggressive induction regime or change to other therapy should be taken into account.

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Abbreviations

IBD:

Inflammatory bowel disease

IL:

Interleukin

IFN-γ:

Interferon gamma

MAdCAM-1:

Mucosal vascular addressin cell adhesion molecule-

PCR:

Polymerase chain reaction

TNF-α:

Tumor necrosis factor alpha

UC:

Ulcerative colitis

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Acknowledgments

This research was supported by grants from the National Defense Medical College and by Intractable Disease Health and Labor Sciences Research grants from the Ministry of Health, Labor, and Welfare.

Conflict of interest disclosure

The authors have nothing to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Hideaki Hozumi, Ryota Hokari, Chie Kurihara, Kazuyuki Narimatsu, Hirokazu Sato, Shingo Sato, Toshihide Ueda, Masaaki Higashiyama, Yoshikiyo Okada, Chikako Watanabe, Shunsuke Komoto, Kengo Tomita, Atsushi Kawaguchi, Shigeaki Nagao & Soichiro Miura

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  1. Hideaki Hozumi
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  2. Ryota Hokari
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  3. Chie Kurihara
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  4. Kazuyuki Narimatsu
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  5. Hirokazu Sato
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  6. Shingo Sato
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  13. Atsushi Kawaguchi
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  14. Shigeaki Nagao
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  15. Soichiro Miura
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Corresponding author

Correspondence to Ryota Hokari.

Additional information

This manuscript was presented as poster presentation at Digestive Disease week 2012 (San Diego, CA, 19–22 May).

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Hozumi, H., Hokari, R., Kurihara, C. et al. Endoscopic finding of spontaneous hemorrhage correlates with tumor necrosis factor alpha expression in colonic mucosa of patients with ulcerative colitis. Int J Colorectal Dis 28, 1049–1055 (2013). https://doi.org/10.1007/s00384-013-1654-4

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  • DOI: https://doi.org/10.1007/s00384-013-1654-4

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