Abstract
The mucosal release of inflammatory mediators is enhanced in active inflammatory bowel disease. This study examines whether leukotriene C4 production occurs in apparently unaffected segments of the gut. The intraluminal release of leukotriene C4 was determined by jejunal perfusion in seven healthy controls, in nine patients with chronic ulcerative colitis, and in 13 patients with Crohn's disease (six with ileal disease, and seven with only colonic). All patients were in clinical remission and none of them had evidence of jejunal involvement. Mild intraluminal irritation with a 2.5 mmol/l deoxycholic acid solution was induced to stimulate local inflammatory mechanisms. The release of DNA (a marker of mucosal desquamation) and prostaglandin E2 (PGE2) was simultaneously measured. Jejunal release of DNA was higher in Crohn's disease patients than in ulcerative colitis or healthy controls. Basal release of PGE2 was similar in the three groups of patients. Basal release of leukotriene C4 was considerably enhanced, however, in Crohn's disease patients compared with healthy controls. In ulcerative colitis patients, basal leukotriene C4 release was non-significantly different from controls. Bile acid perfusion stimulated PGE2, leukotriene C4, and DNA release in all groups studied, but leukotriene C4 release was significantly higher in Crohn's disease patients. It is concluded that in inactive Crohn's disease there is an enhanced intraluminal release of leukotriene C4 in apparently unaffected segments of proximal small bowel, which may reflect fundamental changes in the function of the gut mucosal barrier.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ahrenstedt O., Knutson L., Nilsson B., Nilsson-Ekdahl K., Odlind B., Hällgren R. Enhanced local production of complement components in the small intestines of patients with Crohn's disease. N Engl J Med. 1990 May 10;322(19):1345–1349. doi: 10.1056/NEJM199005103221903. [DOI] [PubMed] [Google Scholar]
- Allgayer H., Deschryver K., Stenson W. F. Treatment with 16,16'-dimethyl prostaglandin E2 before and after induction of colitis with trinitrobenzenesulfonic acid in rats decreases inflammation. Gastroenterology. 1989 May;96(5 Pt 1):1290–1300. doi: 10.1016/s0016-5085(89)80016-2. [DOI] [PubMed] [Google Scholar]
- Gieske T. H., Sabol J. S., Raddatz R. MDL 28,753, an agonist of LTD4 but an antagonist of LTC4 in longitudinal muscle of guinea pig ileum. J Pharmacol Exp Ther. 1990 Jul;254(1):192–197. [PubMed] [Google Scholar]
- Harries J. T., Sladen G. E. The effects of different bile salts on the absorption of fluid, electrolytes, and monosaccharides in the small intestine of the rat in vivo. Gut. 1972 Aug;13(8):596–603. doi: 10.1136/gut.13.8.596. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harvey R. F., Bradshaw J. M. A simple index of Crohn's-disease activity. Lancet. 1980 Mar 8;1(8167):514–514. doi: 10.1016/s0140-6736(80)92767-1. [DOI] [PubMed] [Google Scholar]
- Hällgren R., Colombel J. F., Dahl R., Fredens K., Kruse A., Jacobsen N. O., Venge P., Rambaud J. C. Neutrophil and eosinophil involvement of the small bowel in patients with celiac disease and Crohn's disease: studies on the secretion rate and immunohistochemical localization of granulocyte granule constituents. Am J Med. 1989 Jan;86(1):56–64. doi: 10.1016/0002-9343(89)90230-1. [DOI] [PubMed] [Google Scholar]
- Knutson L., Ahrenstedt O., Odlind B., Hällgren R. The jejunal secretion of histamine is increased in active Crohn's disease. Gastroenterology. 1990 Apr;98(4):849–854. doi: 10.1016/0016-5085(90)90006-m. [DOI] [PubMed] [Google Scholar]
- Lauritsen K., Laursen L. S., Bukhave K., Rask-Madsen J. Effects of topical 5-aminosalicylic acid and prednisolone on prostaglandin E2 and leukotriene B4 levels determined by equilibrium in vivo dialysis of rectum in relapsing ulcerative colitis. Gastroenterology. 1986 Oct;91(4):837–844. doi: 10.1016/0016-5085(86)90684-0. [DOI] [PubMed] [Google Scholar]
- LeDuc L. E., Nast C. C. Chemotactic peptide-induced acute colitis in rabbits. Gastroenterology. 1990 Apr;98(4):929–935. doi: 10.1016/0016-5085(90)90017-u. [DOI] [PubMed] [Google Scholar]
- Peskar B. M., Dreyling K. W., Peskar B. A., May B., Goebell H. Enhanced formation of sulfidopeptide-leukotrienes in ulcerative colitis and Crohn's disease: inhibition by sulfasalazine and 5-aminosalicylic acid. Agents Actions. 1986 Jun;18(3-4):381–383. doi: 10.1007/BF01965001. [DOI] [PubMed] [Google Scholar]
- Redfern J. S., Blair A. J., 3rd, Lee E., Feldman M. Gastrointestinal ulcer formation in rabbits immunized with prostaglandin E2. Gastroenterology. 1987 Oct;93(4):744–752. doi: 10.1016/0016-5085(87)90436-7. [DOI] [PubMed] [Google Scholar]
- TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tangerman A., van Schaik A., van der Hoek E. W. Analysis of conjugated and unconjugated bile acids in serum and jejunal fluid of normal subjects. Clin Chim Acta. 1986 Sep 15;159(2):123–132. doi: 10.1016/0009-8981(86)90044-6. [DOI] [PubMed] [Google Scholar]
- Teem M. V., Phillips S. F. Perfusion of the hamster jejunum with conjugated and unconjugated bile acids: inhibition of water absorption and effects on morphology. Gastroenterology. 1972 Feb;62(2):261–267. [PubMed] [Google Scholar]
- Zipser R. D., Nast C. C., Lee M., Kao H. W., Duke R. In vivo production of leukotriene B4 and leukotriene C4 in rabbit colitis. Relationship to inflammation. Gastroenterology. 1987 Jan;92(1):33–39. doi: 10.1016/0016-5085(87)90836-5. [DOI] [PubMed] [Google Scholar]