Regeneration of Colorectal Epithelium in Diverticulosis

Abstract

Excessive poorly differentiated epitheliocytes were detected in the crypts and subepithelial regions of the colorectal mucosa during the regeneration process in the majority of patients with diverticular disease. The compensatory reaction of the sigmoid mucosa decreased, which was seen from rarely detected cryptic hyperplasia. Disorders in the epitheliocyte proliferation and differentiation were paralleled by changes in tissue levels of proinflammatory cytokines (elevation of TNF-α and IFN-γ and reduction of IL-1β and IL-8) and increase of IL-4, regulating lymphocyte activation.

Do Colonic Mucosal Tumor Necrosis Factor Alpha Levels Play a Role in Diverticular Disease? A Systematic Review and Meta-Analysis

“…Of these, 13 articles were excluded due to the following reasons: (1) 2 were case reports [ 26 , 27 ]; (2) 4 were conference abstracts [ 28 , 29 , 30 , 31 ]; (3) 3 were letters [ 32 , 33 , 34 ]; and (4) 4 were literature reviews [ 13 , 35 , 36 , 37 ]. The overall number of included articles in the qualitative synthesis was 12 studies, among which 6 were included in the quantitative synthesis [ 15 , 17 , 18 , 19 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”

“…The sex distribution was higher for females (472 females (53.45%), 411 males (46.54%)). One study did not specify the sex of the included patients [ 40 ]. DD was present in 449 subjects (50.84%) from the total study sample.…”

“…Colonic diverticula were assessed using colonoscopy for diagnosing DD in most studies (n = 10) [ 15 , 18 , 19 , 38 , 39 , 40 , 41 , 45 ], while two studies used the clinical data reported and used the specimens of the sigmoid colon obtained during sigmoid resection or left hemicolectomy [ 43 , 44 ]. Moreover, two studies used a CT scan for the exclusion of complications in AUD subjects, followed by colonoscopy [ 17 , 42 ].…”

“…There was a significant MD between the DD and IBS subjects in the three studies comparing values on the TNF-α levels, as shown in Figure 4 [ 15 , 37 , 40 ]. The pooled analysis evaluating the TNF-α levels in DD and IBS subjects revealed an overall MD of 27.368 (95% CI 23.744–30.992).…”

“…The symptomatic patients exhibited a higher median relative expression of TNF alpha mRNA compared to the asymptomatic patients. Potapova et al, performed an investigation on 50 participants, including 25 with DD and 25 controls with IBS [ 40 ]. The concentration of TNF-α was significantly higher in DD compared to IBS.…”