Brief Article
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World J Gastrointest Pathophysiol. Aug 15, 2013; 4(3): 53-58
Published online Aug 15, 2013. doi: 10.4291/wjgp.v4.i3.53
Altered molecular pattern of mucosal healing in Crohn’s disease fibrotic stenosis
Enzo Ierardi, Floriana Giorgio, Domenico Piscitelli, Mariabeatrice Principi, Santina Cantatore, Maria Grazia Fiore, Roberta Rossi, Michele Barone, Alfredo Di Leo, Carmine Panella
Enzo Ierardi, Floriana Giorgio, Santina Cantatore, Michele Barone, Carmine Panella, Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy
Domenico Piscitelli, Mariabeatrice Principi, Maria Grazia Fiore, Roberta Rossi, Alfredo Di Leo, Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy
Author contributions: Ierardi E, Barone M, Di Leo A and Panella C designed the study, revised the manuscript and approved the final version; Giorgio F, Piscitelli D, Principi M, Fiore MG and Rossi R collected the data; Cantatore S performed immunohistochemistry.
Correspondence to: Enzo Ierardi, Professor, Gsatroenterology, Department of Medical and Surgical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 71100 Foggia, Italy. enzo.ierardi@fastwenet.it
Telephone: +39-8-81736204 Fax: +39-8-81733848
Received: April 6, 2013
Revised: June 17, 2013
Accepted: July 18, 2013
Published online: August 15, 2013
Abstract

AIM: To investigate tumor necrosis factor-α (TNF-α), syndecan 1 and basic fibroblast growth factor (bFGF) balance in Crohn’s disease (CD) strictures.

METHODS: Our study was performed on 24 surgical specimens of CD fibrotic stenosis. Ten histological normal surgical samples were retrieved for both the large and small bowel from patients with benign conditions and healthy tissue represented control collection. Sex and age in controls did not differ from CD group. Three endoscopic biopsy specimens taken after informed consent in subjects with normal colon were also used as negative controls. TNF-α, syndecan 1 and bFGF were detected by both reverse transcriptase reverse transcriptase polymerase chain reaction after mRNA extraction (results expressed as fold-change) and immunohistochemistry.

RESULTS: TNF-α did not show any significant difference between CD and control specimens (1.54 ± 1.19; P > 0.05). Very high levels of bFGF were observed in CD (11.76 ± 4.65; P < 0.001) unlike syndecan 1 which showed a moderate increase (5.53 ± 2.18; P < 0.005). analysis of variance (ANOVA) plus Student-Neumann-Keuls showed: bFGF > syndecan 1 > TNF-α = control. Immunoreactivity for bFGF was observed in epithelial, stromal, endothelial cells and even in the muscular layer, whilst in normal tissue it was almost unexpressed. Syndecan 1 and TNF-α staining was confined to mucosal epithelial and stromal cells, while in controls syndecan 1 was found in its normal site, i.e., basolateral area of the crypts and TNF-α very poorly expressed.

CONCLUSION: Fibrotic stenosis of CD may be the final result of an irreversible transformation of different cells into fibrogenic phenotype no longer inhibited by post-transcriptional regulation.

Keywords: Crohn’s disease, Fibrotic stenosis, Tumor necrosis factor-α, Syndecan 1, Basic fibroblast growth factor

Core tip: The present manuscript reports a study of molecular pattern in the course of stenotic complication of Crohn’s disease. We have studied the interaction among the main cytokine [tumor necrosis factor-α (TNF-α)], an adhesion molecule (syndecan 1) and a growth factor basic fibroblast growth factor which are strictly involved in damage repair and mucosal healing, as showed in a previous study. In this study we demonstrated that a deep dysregulation of interaction of these three factors may support stenotic fibrosis in Crohn’s disease and suggest that this condition needs to be investigated before a biological treatment since TNF-α lack downregulation could further stimulate fibrogenesis.