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Fecal stream diversion and mucosal cytokine levels in collagenous colitis: A case report
University of Örebro, Sweden.
University of Örebro, Sweden.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics.
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2015 (English)In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 21, no 19, 6065-6071 p.Article in journal (Refereed) Published
Abstract [en]

In this case report, we examined the levels of cytokines expressed before and during fecal stream diversion and after intestinal continuity was restored in a patient with collagenous colitis. We report the case of a 46-year-old woman with chronic, active collagenous colitis who either failed to achieve clinical remission or experienced adverse effects with the following drugs: loperamide, cholestyramine, budesonide, methotrexate and adalimumab. Due to the intractable nature of the disease and because the patient was having up to 15 watery bowel movements per day, she underwent a temporary ileostomy. Colonic biopsies were analyzed for mucosal cytokine protein levels before and during fecal stream diversion and after intestinal continuity was restored. Mucosal protein levels of interleukin (IL)-1 beta, IL-2, IL-6, IL-12, IL-17 A, IL-23, TNF, IFN-gamma, IL-4, IL-5, IL-10 and IL-13 were all higher during active disease and decreased to non-detectable or considerably lower levels during fecal stream diversion. One month after the restoration of bowel continuity, when the patient experienced a relapse of symptoms, IL-2, IL-23 and IL-21 levels were again increased. Our results indicate that fecal stream diversion in this patient suppressed the levels of all cytokines analyzed in colonic biopsies. With the recurrence of clinical symptoms and histological changes after bowel reconstruction, the levels of primarily proinflammatory cytokines increased. Our findings support the hypothesis that a luminal factor triggers the inflammation observed in collagenous colitis.

Place, publisher, year, edition, pages
Baishideng Publishing Group Co. Limited , 2015. Vol. 21, no 19, 6065-6071 p.
Keyword [en]
Microscopic colitis; Collagenous colitis; Luminex; Mucosal cytokines; Fecal stream diversion
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-119587DOI: 10.3748/wjg.v21.i19.6065ISI: 000355115600036PubMedID: 26019474OAI: oai:DiVA.org:liu-119587DiVA: diva2:825141
Note

Funding Agencies|Abbott; dr Falk Pharma

Available from: 2015-06-23 Created: 2015-06-22 Last updated: 2016-04-12

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Ignatova, SimoneStröm, MagnusMünch, Andreas
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Department of Clinical and Experimental MedicineFaculty of Health SciencesDepartment of Clinical Pathology and Clinical GeneticsDivision of Neuro and Inflammation ScienceDepartment of GastroentorologyFaculty of Medicine and Health Sciences
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World Journal of Gastroenterology
Gastroenterology and Hepatology

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