Leucocyte typing, cytokine expression, and epithelial turnover in the ileal pouch in patients with ulcerative colitis and familial adenomatous polyposis.

Goldberg, P. A.; Herbst, F.; Beckett, Conrad; Martelli, B; Kontakou, M; Talbot, I. C.; Ciclitira, Paul J.; Nicholls, R. J.

doi:10.1136/gut.38.4.549

Cited by 43 publications

(19 citation statements)

References 16 publications

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“…4 Histological examination of pouchitis reveals acute inflammatory infiltrates with crypt abscesses and ulceration. 5,6 Pouchitis occurs in 7%-42% of patients with UC, 7 and is much more common in patients with UC than in those with FAP who have an ileal pouch. The etiology of pouchitis is not known.…”

mentioning

confidence: 98%

Proliferation of immature plasma cells in pouchitis mucosa in patients with ulcerative colitis

Hirata

Oshitani

Kamata

et al. 2008

Inflammatory Bowel Diseases

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mentioning

confidence: 98%

Proliferation of immature plasma cells in pouchitis mucosa in patients with ulcerative colitis

Hirata

Oshitani

Kamata

et al. 2008

Inflammatory Bowel Diseases

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“…Proinflammatory cytokines such as tumor necrosis factor (TNF)-α IL-1, IL-8, and IL-12 play a pivotal role in initiating and exacerbating the inflammatory reaction, whereas their endogenous inhibitors (IL-l receptor antagonist), soluble TNF receptors, and immunoregulatory cytokines (IL-4, IL-10, IL-13) limit and downregulate inflammatory response. Abnormalities in cytokine production have been reported in pouchitis, as manifested by the deregulated production of proinflammatory and immunoregulatory cytokines [41]. The cytokines can affect the activity, differentiation, and proliferation of a variety of cells and can mediate the tissue injury.…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Pouchitis: A spectrum of diseases

Shen

Lashner

2005

Curr Gastroenterol Rep

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Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for ulcerative colitis and familial adenomatous polyposis patients who require surgery. Pouchitis is the most common long-term complication after IPAA. Patients with pouchitis represent a heterogeneous group in terms of pathogenesis, clinical presentation, disease course, and prognosis, suggesting a wide range of disease mechanisms. Before the diagnosis of pouchitis is made, other inflammatory and non-inflammatory disease conditions, such as Crohn's disease, cuffitis, and irritable pouch syndrome, should be ruled out. Pouch endoscopy is the most important tool for diagnosis and differential diagnosis. Accurate diagnosis and classification are essential for appropriate management. Although the majority of patients with pouchitis respond to antibiotic therapy, a subset of these patients cannot achieve remission by means of antibiotics and thus require anti-inflammatory or immunosuppressive treatment.

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“…As a result of activation of T cells and other immune cells, production of cytokines is up-regulated. Abnormal cytokine profiles have been reported in pouchitis including a deregulated production of proinflammatory and immunoregulatory cytokines [28].…”

Section: Pathophysiologymentioning

confidence: 99%

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

et al. 2010

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Ileal pouch-anal anastomosis (IPAA) is now the procedure of choice for most patients requiring proctocolectomy for ulcerative colitis. The J-shaped pouch, usually 15-20 cm in length, is easiest to construct and has functional outcomes identical to those of the more complex designs. IPAA is a complex procedure, and complications occur frequently. Despite the significant improvements this surgical advance has made on the quality of life in these patients, inflammation of the surgically created ileal pouch or pouchitis remains a major late postoperative complication that can often overshadow the benefits of this otherwise curative operation. Several inflammatory and noninflammatory complications can occur after IPAA. Pouchitis is the most common, occurring in ≈50% of patients. Whereas acute pouchitis can be treated rapidly and successfully in the majority of patients, refractory and chronic pouchitis remain therapeutic challenges to patients and physicians. The problem is believed to be caused by stasis of feces in the pouch with overgrowth of aerobic and anaerobic organisms. The size of the pouch has a significant influence on the incidence of pouchitis: a smaller pouch usually empties better than a larger pouch and so may be less susceptible to pouchitis.

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Leucocyte typing, cytokine expression, and epithelial turnover in the ileal pouch in patients with ulcerative colitis and familial adenomatous polyposis.

Abstract: Background/Aims-Conventional histopathology, leucocyte typing, cytokine mRNA expression, and crypt cell turnover were compared in ileal pouch biopsy specimens from patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP (Gut 1996; 38: 549-553)

Cited by 43 publications

References 16 publications

Proliferation of immature plasma cells in pouchitis mucosa in patients with ulcerative colitis

Proliferation of immature plasma cells in pouchitis mucosa in patients with ulcerative colitis

Pouchitis: A spectrum of diseases

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

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