Digestive Diseases and Sciences

, Volume 42, Issue 2, pp 394–403

Quantification of Inflammatory Mediators in Stool Samples of Patients with Inflammatory Bowel Disorders and Controls

  • S. C. Bischoff
  • J. Grabowsky
  • M. P. Manns
Article

Abstract

Previous studies indicated that eosinophils andmast cells accumulate and become activated ininflammatory bowel disorders. The aim of the study wasto examine the presence of eosinophil and mast cellmediators in human stool samples of patients withinflammatory bowel disorders. We measured eosinophilcationic protein (ECP), eosinophil protein ×(EPX), methylhistamine, andα1-antitrypsin in fecal samples of 136 patients (62 Crohn's 1 disease, 24ulcerative colitis, 15 intestinal food allergy, 35 othergastrointestinal diseases) and 8 healthy controls. Wefound strongly elevated levels of ECP (median: 29,range: 0.4-1783 ng/g feces) and EPX (803, 10-33,225ng/g) in all patient groups compared to controls (ECP:1.5, 0.5-55 ng/g; EPX: 235, 12-746 ng/g). Similarresults, albeit less pronounced, were obtained formethylhistamine and alpha1-antitrypsin. Particularly highconcentrations of ECP and EPX were found in patientswith active mucosal inflammation. In conclusion, thestudy presents an easy and reliable method for thedetection of fecal ECP, EPX, and methylhistamine and mayprovide a tool to gain insight into the pathogenesis ofinflammatory bowel diseases and have potential asdiagnostic test.

INFLAMMATORY BOWEL DISEASE EOSINOPHILS MAST CELLS α1-ANTITRYPSIN 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Lowes JR, Jewel DP: The immunology of inflammatory bowel disease. Springer Sem Immunopathol 12:251–268, 1990Google Scholar
  2. 2.
    Marsh MN, Ensari A, Morgan S: Evidence that gluten sensitivity is an immunologic disease. Curr Opin Gastroenterol 9:994–1000, 1993Google Scholar
  3. 3.
    Cominelli F, Kam L: Inflammatory mediators of inflammatory bowel disease. Curr Opin Gastroenterol 9:534–542, 1993Google Scholar
  4. 4.
    Sartor RB: Cytokines in intestinal inflammation: Pathophysiological and clinical considerations. Gastroenterology 106:533–539, 1994Google Scholar
  5. 5.
    Marsh MN, Hinde J: Inflammatory components of celiac sprue mucosa. I. Mast cells, basophils and eosinophils. Gastroenterology 89:92–101, 1985Google Scholar
  6. 6.
    Talley NJ, Kephart GM, McGovern TW, Carpenter HA, Gleich GJ: Deposition of eosinophil granule major basic protein in eosinophilic gastroenteritis and celiac disease. Gastroenterology 103:137–145, 1992Google Scholar
  7. 7.
    Dubucquoi S, Janin A, Klein O, Desreumaux P, Quandalle P, Cortot A, Capron A, Colombel JF: Activated eosinophils and interleukin 5 expression in early recurrence of Crohn's disease. Gut 37:242–246, 1995Google Scholar
  8. 8.
    Bischoff SC, Wedemeyer J, Herrmann A, Meier PN, Trautwein C, Cetin Y, Maschek H, Stolte M, Gebel M, Manns MP: Quantitative assessment of intestinal eosinophils and mast cells in inflammatory bowel disease. Histopathology 28:1–13, 1996Google Scholar
  9. 9.
    Furuta GT, Ackerman SJ, Wershil BK: The role of eosinophils in gastrointestinal diseases. Curr Opin Gastroenterol 11:541–547, 1995Google Scholar
  10. 10.
    Levy AM, Kita K: The eosinophil in gut inflammation: effector or director? Gastroenterology 110:952–954, 1996Google Scholar
  11. 11.
    Galli SJ: New concepts about the mast cell. N Engl J Med 328:257–265, 1993Google Scholar
  12. 12.
    Bousquet J, Chanez P, Lacoste JY, Barneon G, Ghavanian N, Enander I, Venge P, Ahlstedt S, Simony-Lafontaine J, Godard P, Michel FB: Eosinophilic inflammation in asthma. N Engl J Med 323:1033–1039, 1990Google Scholar
  13. 13.
    Charlesworth EN, Hood AF, Soter NA, Kagey-Sobotka A, Norman PS, Lichtenstein LM: Cutaneous late-phase response to allergen. Mediator release and inflammatory cell infiltration. J Clin Invest 83:1519–1526, 1989Google Scholar
  14. 14.
    Crowe SE, Perdue MH: Gastrointestinal food hypersensitivity: Basic mechanisms of pathophysiology. Gastroenterology 103:1075–1095, 1992Google Scholar
  15. 15.
    Bischoff SC, Herrman A, Mayer J, Manns MP: Food allergy in patients with gastrointestinal disease. In Highlights in Food Allergy, Monographs in Allergy 32. B. Wüthrich, C. Ortolani C (eds). Basel, Karger, 1996, pp 130–142Google Scholar
  16. 16.
    Ferguson A, Gilett H, O'Mahony S: Active immunity or tolerance to food in patients with celiac disease or inflammatory bowel disease. Ann NY Acad Sci 778(13):202–216, 1996Google Scholar
  17. 17.
    Pearson M, Teahon K, Levi AJ, Bjarnason I: Food intolerance and Crohn's disease. Gut 34:783–787, 1993Google Scholar
  18. 18.
    Hällgren R, Colombel JF, Dahl R, Fredens K, Kruse A, Jacobson NO, Venge P, Rambaud JC: Neutrophil and eosinophil involvement of the small bowel in patients with celiac disease and Crohn's disease: Studies on the secretion rate and immunohistochemical localization of granulocyte granule constituents. Am J Med 86:56–64, 1989Google Scholar
  19. 19.
    Knutson L, Ahrenstedt Ö, Odling B, Hällgren R: The jejunal secretion of histamine is increased in active Crohn's disease. Gastroenterology 98:849–854, 1990Google Scholar
  20. 20.
    Casellas F, Guarner F, Antolin M, Rodriguez R, Slas A, Malagelada JR: Abnormal leukotriene C4 release by unaffected jejunal mucosa in patients with inactive Crohn's disease. Gut 35:517–522, 1994Google Scholar
  21. 21.
    Peterson CGB, Venge P: Purification and characterization of a new cationic protein—eosinophil protein X (EPX)—from granulocytes of human eosinophils. Immunology 50:19–26, 1983Google Scholar
  22. 22.
    Peterson CGB, Jörnvall H, Venge P: Purification and characterization of eosinophil cationic protein from normal human eosinophils. Eur J Haematol 40:415–423, 1988Google Scholar
  23. 23.
    Abu-Ghazaleh RI, Dunnette SL, Loegering DA, Checkel JL, Kita H, Thomas LL, Gleich GJ: Eosinophil granule proteins in peripheral blood granulocytes. J Leukocyte Biol 52:611–618, 1992Google Scholar
  24. 24.
    Meyers S, Wolke A, Field SP, Feuer EJ, Johnson JW, Janowitz HD: Fecal α1-antitrypsin measurement: An indicator of Crohn's disease activity. Gastroenterology 89:13–18, 1985Google Scholar
  25. 25.
    Lopez A, Hinojosa J, Mirralles A, Primo J, Bermudez JD: Fecal excretion of α1-antitrypsin in patients with Crohn's disease. A comparison of nephelometry and radial immunodiffusion. 39:507–512, 1994Google Scholar
  26. 26.
    Best WR, Becktel JM, Singleton JW, Kern R: Development of a Crohn's disease activity index. Gastroenterology 70:439–444, 1976Google Scholar
  27. 27.
    Rachmilewitz D: Coated mesalazine (5-aminosalicylic acid) versus sulfalazine in the treatment of active ulcerative colitis: A randomised trial. Br Med J 298:82–86, 1989Google Scholar
  28. 28.
    Bischoff SC, Herrmann A, Manns MP: Prevalence of adverse reactions to food in patients with gastrointestinal disease. Allergy 51:811–818, 1996Google Scholar
  29. 29.
    Berstad A, Borkje B, Riedel B, Elsayed S, Berstad A: Increased fecal eosinophil cationic protein in inflammatory bowel disease. Hepato-Gastroenterology 40:276–278, 1993Google Scholar
  30. 30.
    Ferguson A, Humphreys KA, Croft NM: Technical report: Results of immunological tests on faecal extracts are likely to be extremely misleading. Clin Exp Immunol 99:70–75, 1995Google Scholar
  31. 31.
    van de Kamer JH, Huinik HB, Weyers HA: Rapid method for the determination of fat in feces. J Biol Chem 2:347–355, 1949Google Scholar
  32. 32.
    Dominguez-Munoz JE, Hieronymus C, Sauerbruch T, Malfertheiner P: Fecal elastase test: Evaluation of a new noninvasive pancreatic function test. Am J Gastroenterol 90:1834–1837, 1995Google Scholar
  33. 33.
    Braegger CP, Nicholls S, Murch SH, Stephens S, MacDonald TT: Tumour necrosis factor alpha in stool as a marker of intestinal inflammation. Lancet 339:89–91, 1992Google Scholar
  34. 34.
    Cellier C, Sahmoud T, Froguel E, Adenis A, Belaiche J, Bretagne JF, Florent C, Bouvry M, Mary JY, Modigliani R, Groupe d'Etudes Thérapeutiques des Affections Inflammatoires Digestives: Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn's disease. A prospective multicentre study of 121 cases. Gut 35:231–235, 1994Google Scholar
  35. 35.
    Lavo B, Knutson L, Lööf L, Odlind B, Venge P, Hällgren R: Challenge with gliadin induces eosinophil and mast cell activation in the jejunum of patients with celiac disease. Am J Med 87:655–660, 1989Google Scholar
  36. 36.
    Liu LX, Chi J, Upton MP, Ash LR: Eosinophilic colitis associated with larvae of the pinworm enterobius vermicularis. Lancet 346:410–412, 1995Google Scholar
  37. 37.
    Clouse RE, Alpers DH, Hockenberg DM, DeSchryver-Kecskemeti K: Pericrypt eosinophilic enterocolitis and chronic diarrhea. Gastroenterology 103:168–176, 1992Google Scholar
  38. 38.
    Colombel JF, Hällgren R, Venge P, Mesnard B, Rambaud JC: Neutrophil and eosinophil involvement of the small bowel affected by chronic alcoholism. Gut 29:1656–1660, 1988Google Scholar
  39. 39.
    Heatley RV, James PD: Eosinophils in the rectal mucosa. A simple method of predicting the outcome of ulcerative proctocolitis? Gut 20:787–791, 1978Google Scholar

Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • S. C. Bischoff
  • J. Grabowsky
  • M. P. Manns

There are no affiliations available

Personalised recommendations