Basic Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2006; 12(7): 1056-1062
Published online Feb 21, 2006. doi: 10.3748/wjg.v12.i7.1056
Relationships between mucinous gastric carcinoma, MUC2 expression and survival
Karlheinz Kiehne, Gabriele Brunke, Franziska Wegner, Tomas Banasiewicz, Ulrich R Fölsch, Karl-Heinz Herzig
Karlheinz Kiehne, Gabriele Brunke, Franziska Wegner, Ulrich R Fölsch, I. Department of Internal Medicine, Universitätsklinikum Schleswig Holstein, Schittenhelmstr. 12, Kiel 24105, Germany
Tomas Banasiewicz, Department of Surgery, Karol Marcinowski University, Poznan, Poland
Karl-Heinz Herzig, A. I. Virtanen Institute for Molecular Sciences, Dept. of Surgery, Kuopio University Hospital, University of Kuopio, Finland
Supported by the Deutsche Forschungsgemeinschaft (SFB 617) and in part by a grant of the Finnish Gastroenterological Society.
Correspondence to: Karlheinz Kiehne, I. Department of Internal Medicine, Universitätsklinikum Schleswig Holstein, Schittenhelmstr. 12, Kiel 24105, Germany.
Telephone: +49-431-5971393 Fax: +40-431-5971302
Received: February 17, 2005
Revised: July 2, 2005
Accepted: July 28, 2005
Published online: February 21, 2006

AIM: Pouchitis develops in ileoanal pouches in up to 50% of patients with ulcerative colitis during the first 10 years after pouch surgery while being rare in patients after proctocolectomy for familial adenomatous polyposis coli (FAP) syndrome. Defensins are major components of the innate immune system and play a significant role in gastrointestinal microbial homeostasis. Pouch defensin and cytokine expression were correlated with states of pouch inflammation to study their role in pouchitis.

METHODS: Patients with ulcerative colitis and FAP syndrome were stratified into groups with pouches after surgery, pouches without or with pouchitis. Biopsies from terminal ileum from a healthy intestine or from normal terminal ileum of patients with ulcerative colitis served as controls. mRNA from pouches and controls was analysed for defensin and cytokine expression.

RESULTS: Expression of defensins was increased in all pouches immediately after surgery, compared to ileum of controls. Initially, pouches in ulcerative colitis revealed higher defensin expression than FAP pouches. Defensin expression declined in both patient groups and increased again slightly in pouchitis in patients with ulcerative colitis. FAP pouches without pouchitis had strong expression of β-defensin hBD-1, while all other defensins remained at low levels. Cytokine expression in ulcerative colitis pouches was high, while FAP pouches showed moderately elevated cytokines only after surgery.

CONCLUSION: Development of pouchitis correlates with decreased defensin expression in ulcerative colitis in addition to high expression of cytokines. The low incidence of pouchitis in FAP pouches correlates with increased expression of hBD-1 β- defensin in association with low cytokine levels.

Keywords: Innate immunity, Ulcerative colitis, Defensins, Pouchitis, Cytokines