Controlled trial of 4-ASA in ulcerative colitis.

A six-week placebo-controlled trial of the efficacy and safety of 6 g per day of 4-aminosalicylic acid (4-ASA) was conducted in 30 subjects with mild to moderately severe ulcerative colitis. Subjects were stratified into groups having distal (< 60 cm) or more extensive (> 60 cm) disease. Diarrhea, bleeding, sigmoidoscopic and biopsy appearance, and physician global assessment were scored to judge efficacy.

Monocyte chemoattractant activity associated with human colon mucosal cells.

Mucosal epithelial cell preparations from 18 disease-free segments of human colon resections and 7 cell lines were examined for chemoattractant properties. Mucosal cells were dissociated from lamina propria by sequential incubations in ethylenediaminetetraacetic acid, harvested at 1.5 x 10(6) cells/ml, and lysed.

The chemotactic response of blood neutrophils and monocytes to strains of Escherichia coli with different virulence characteristics.

Chemotactic responses of blood neutrophils and monocytes to media conditioned by eight strains of Escherichia coli with different virulence characteristics were measured in modified Boyden assay chambers to determine if these characteristics were associated with differences in leucocyte mobility. Responding neutrophils and monocytes were prepared on conventional density gradients, and in three instances, the chemotaxis of eosinophils isolated on metrizamide gradients was also studied. Media conditioned by enteroinvasive and nonenteroinvasive E.

Pneumatosis intestinalis in patients with Crohn's disease.

The prevalence, predictors, and significance of pneumatosis were determined in 50 patients with Crohn's disease who had abdominal CT scans to rule out abscess. The presence or absence of six CT descriptors and 17 clinical descriptors was documented. CT scans of a control group of 50 subjects without inflammatory bowel disease were also examined.

Dietary supplementation with fish oil in ulcerative colitis.

Objective: To determine the efficacy of fish oil supplementation in patients with active ulcerative colitis.

Design: Multicenter, randomized, double-blind, placebo-controlled, crossover trail with 4-month treatment periods (fish oil and placebo) separated by a 1-month washout.

Setting: Four gastroenterology divisions.

140-MDa plasmids of Escherichia coli and Shigella flexneri 5 do not influence phagocytosis.

Enteroinvasive Escherichia coli (EIEC) and Shigella flexneri possessing a 140-megadalton (MDa) plasmid are capable of invading intestinal epithelial cells and causing dysentery. To determine if this plasmid affected phagocytosis of the organisms by leukocytes, we studied the in vitro phagocytosis of isogenic pairs of EIEC and S. flexneri 5 which differed only in the presence or absence of the 140-MDa plasmid.

Luminal concentrations of orally ingested 4-aminosalicylic acid as determined by in-vivo equilibrium dialysis.

We measured 4-aminosalicylic acid (4-ASA) levels in faecal water by in-vivo equilibrium dialysis during oral ingestion of drug by two different dose protocols (A and B). In Protocol A, 5 normal subjects ingested 3 g of 4-ASA as the free acid and 20 mg of metaclopromide per day. On Day 5, small dialysis sacs filled with dextran 40 were ingested and the oral drug was continued until the sacs were retrieved from the stool.

Association and linkage studies of immunoglobulin heavy chain allotypes in inflammatory bowel disease.

Inflammatory bowel disease is a familial disorder of unknown etiology, characterized by a variety of immunological abnormalities for which there are no proven genetic markers. Studies of immunoglobulin heavy chain and light chain allotypes were undertaken in 89 patients with Crohn's disease and in 18 families with ulcerative colitis or Crohn's disease in at least two first-degree relatives, to search for association and/or linkage between a postulated disease susceptibility locus and an immunoglobulin allotype locus. No evidence of association or linkage with a specific immunoglobulin allotype was found.

Phagocytes in cell suspensions of human colon mucosa.

Because little is known of the phagocytes of the human colon we enumerated these cells in mucosal suspensions and studied their phagocytic activity. Phagocyte rich suspensions were made by EDTA collagenase dissociation followed by elutriation centrifugation. Phagocytosis was evaluated by measuring cellular radioactivity after incubation of phagocytes with 3H-adenine labelled E coli ON2 and checked microscopically.

Eosinophils of human colonic mucosa: C3b and Fc gamma receptor expression and phagocytic capabilities.

Because little is known about eosinophils of the human intestine, we measured their C3b and Fc gamma receptor expression and phagocytic activity in mucosal suspensions from colon resections for large bowel neoplasms. Enzymatically dissociated suspensions were enriched for eosinophils by countercurrent centrifugation. C3b and Fc gamma receptors were measured by immunofluorescent assays with flow cytometry.

Crohn's disease in the elderly. A statistical comparison with younger patients matched for sex and duration of disease.

To better characterize Crohn's disease in the elderly, 24 patients ranging in age from 64 to 85 years were reviewed and compared with a younger group (20 to 61 years of age) matched for sex and duration of disease. Forty-one variables encompassing clinical, laboratory, and radiologic data and medical and surgical aspects of treatment were analyzed. The older group was characterized by a longer delay in diagnosis, more hematochezia, and a higher incidence of diverticular and cardiovascular disease.

In vitro cellular cytotoxicity for a human colon cancer cell line by mucosal mononuclear cells of patients with colon cancer and other disorders.

In vitro cellular cytotoxicity of mononuclear cells of intestinal mucosa and peripheral blood for a colon cancer cell target was measured in patients with colon cancer and other disorders requiring resection. Four- and 24-hour cytotoxicity assays were conducted using selenium 75 (75Se)-labeled RPMI-4788 human colon cancer target cells grown in culture. In the cancer group mean cytotoxicity was 30.

Enrichment of macrophages in cell suspensions of human intestinal mucosa by elutriation centrifugation.

To obtain macrophage-rich cell suspensions from human intestinal mucosa, lamina propria specimens were dissociated by incubating in EDTA-collagenase-DNAase solutions and further purified by counter-current centrifugation. During enzymatic incubation macrophage dissociation was linear over the first 8-10 h, reaching a maximum concentration of 10% of total cells and then it plateaued. Counter-current centrifugation resulted in a 5-fold enrichment of macrophages to a mean of 50% with an average recovery rate of 84%.

Disseminated gastrointestinal sarcoidosis. Case report and review of the literature.

A patient with long-standing sarcoidosis was found to have jejunal atrophy and nonnecrotizing granulomas of the stomach, small bowel, and colon when she presented with malabsorption. There were no radiologic abnormalities of the gastrointestinal tract. Symptoms of malabsorption rapidly abated with corticosteroid treatment given for severe pulmonary disease.

Comparative studies of mononuclear phagocyte function in patients with Crohn's disease and colon neoplasms.

Phagocytosis and cellular cytotoxicity by mononuclear phagocytes of blood and intestinal mucosa were studied in patients with Crohn's disease and large bowel neoplasms. Antibody coated sheep erythrocytes were used for phagocytic assays and cellular cytotoxicity in vitro was measured by 24 hour isotope release from 75Selenium methionine-labelled RPMI 4788 human cancer cell cultures in the presence of mononuclear phagocyte-enriched effector populations. The mean percent of mononuclear phagocytes in Ficoll-Hypaque purified mononuclear cell suspensions of blood of healthy controls was 25.

Depressed spontaneous cell-mediated cytotoxicity in Crohn's disease.

Cytotoxicity of peripheral blood mononuclear cells of 30 patients with Crohn's disease (CD) and 30 matched controls was assayed by measuring isotope release from 75Se-L-methionine labelled RPMI 4788 human colon cancer cells. Effector populations were studied with and without monocyte depletion after 4 and 24 hr incubations in 10% fetal calf serum or autologous serum or plasma. Cytotoxicity was negligible at 4 hr.

HLA B8 and granuloma formation in Crohn's disease.

In a retrospective survey, patients with Crohn's disease who were HLA B8 were found to have significantly fewer granulomas in rectal biopsies (p less than 0.002) and in resected bowel specimens (p less than 0.02) than non-HLA B8 patients.

Isolation of Clostridium difficile from patients with inactive Crohn's disease.

Based upon studies of patients with inflammatory bowel disease, Clostridium difficile and an associated cytotoxin have been proposed as contributory factors in relapse of disease. These studies have not included a comprehensive search for other bacterial pathogens. Fifty patients with Crohn's disease were investigated to determine if selected enteric pathogens colonize the bowel and if they play a role in the activity of the disease.

Lymphocytotoxic and microbial antibodies in Crohn's disease and matched controls.

Patients with Crohn's disease and age, sex and seasonally matched healthy controls were studied for cold lymphocytotoxic and a variety of microbial antibodies. Lymphocytotoxic antibody titers were increased significantly in the Crohn's patients compared to controls, but did not correlate with any of the microbial titers. Antibodies to a Pseudomonas-like bacterium and Bacteroides vulgatus were also increased in the patients, but titers to Chlamydia trachomatis, rotavirus and Norwalk virus were not elevated above control values.

Comparative viabilities of rat intestinal epithelial cells prepared by mechanical, enzymatic and chelating methods.

Mechanical, enzymatic and chelating methods for isolating rat intestinal epithelial cells were compared to determine the best technique for obtaining high yields of viable cells. The mechanical techniques resulted in consistently poor viability compared with the other methods. There was excellent agreement between viability determinations made by trypan blue exclusion and by cytofluorochromasia.

Discordant HLA haplotype segregation in familial Crohn's disease.

To look for possible HLA linkage in familial Crohn's disease, HLA haplotype segregation patterns were determined in 70 members of five kindreds, each having 2 or more patients with Crohn's disease (total number: 13 with Crohn's disease, 1 with ulcerative colitis). Concordant segregation of HLA haplotypes and disease was not observed. Study of HLA A and B locus phenotypes in 64 additional patients with documented Crohn's disease failed to show any significant disease association.

Lymphocyte subpopulations of intestinal mucosa in inflammatory bowel disease.

Lymphocyte subpopulations in peripheral blood (PBL) and intestinal mucosa (IML) of 10 patients with inflammatory bowel disease (IBD) were compared with those of 11 non-IBD controls. PBL were separated on Ficoll/hypaque gradients, and IML were isolated by incubation in dithiothreitol, EDTA, and collagenase. These methods yielded cells of good viability and with intact HLA A and B-antigens.