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

AI Article Synopsis

  • Ulcerative colitis (UC) is a challenging bowel disease, and recent studies suggest that the expression of a specific protein, TNF-α, could help predict how well patients respond to a treatment called infliximab.
  • This study involved 159 UC patients, analyzing colonic tissue samples to measure levels of various inflammatory molecules and comparing those levels to endoscopic findings of disease severity.
  • Results showed that higher levels of TNF-α and other cytokines were linked to more severe endoscopic findings, particularly in cases where there was spontaneous bleeding, indicating a potential for poorer treatment responses in those patients.

Article 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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Source
http://dx.doi.org/10.1007/s00384-013-1654-4DOI Listing

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