Markers of Inflammation and Lineage on Exfoliated Colonic Cells In Pediatric Inflammatory Bowel Disease

Abstract

Objectives The diagnosis (endoscopy, and biopsy) and continued clinical management of Inflammatory Bowel Disease (IBD), remain highly invasive, expensive, and inconvenient for the pediatric patient. The objective of this study was to see if colonocytes obtained from stools of subjects with IBD and normal controls would demonstrate higher levels of inflammatory markers (Cox 2 in CD45+ and CD45− cells) and if the inflammatory process and treatment effects would be reflected in an altered cytokine expression in the subjects compared to controls. Setting Outpatient hospital based pediatric gastroenterology clinic. Methods and Main outcome measures Stool samples (~ 1 gm), were obtained from 18 children between the ages of 4 and 18 diagnosed with IBD, and from a normal first degree relative. Colonocytes were isolated using the Somatic Cell Sampling Recovery (SCSR) system and assessed for the expression of COX-2, CD-45, IgA, IgG, IL6, IL18, TGF β, TNF, and IL16β using flow cytometry. In addition, levels of COX-2 and cytokeratin 19 transcripts were measured by microwell plate hybridization assay. Results Expression of COX-2 and co-expression of IgA and IgG were significantly higher in the IBD cases compared to the controls. In ulcerative colitis, the expression of COX-2 and co-expression of COX-2 and CD45 were greater than that in patients with Crohn’s disease. In contrast, cells expressing IgA and IgG were higher in Crohn’s. Subjects on immunosuppressants and/or anti-inflammatory medications, expressed significantly lower levels of COX-2 and IL-18 compared to those who were not on treatment. Conclusions This study indicates that the use of disease markers on exfoliated colonic cells can be used for non-invasive assessment of disease status, for follow-up of response to treatment and for forecasting flare-up of disease before its symptomatic manifestations.

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“…4G). COX-2 is recognized as a reliable marker of colonic mucosal inflammation, and its expression has been shown to be markedly higher in IBD patients compared to healthy controls (31). Additionally, multiple studies have demonstrated that the IL-1 signaling pathway is involved in COX-2 up-regulation (32)(33)(34).…”

The Anti-Inflammatory Effect and Mucosal Barrier Protection of Clostridium butyricum RH2 in Ceftriaxone-Induced Intestinal Dysbacteriosis

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Immunoglobulin receptors expression in indian colon cancer patients and healthy subjects using a noninvasive approach and flowcytometry

“…[ 10 ] Another study also reported the use of this noninvasive technique to isolate viable colonocytes from stools in IBD individuals and normal controls and showed altered levels of inflammatory markers and cytokine expression in the IBD individuals compared to controls. [ 23 ]…”