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. 2000 Jan;46(1):40–45. doi: 10.1136/gut.46.1.40

Diversion of intestinal flow decreases the numbers of interleukin 4 secreting and interferon γ secreting T lymphocytes in small bowel mucosa

A Schmit 1, A Van Gossum 1, M Carol 1, J Houben 1, F Mascart 1
PMCID: PMC1727786  PMID: 10601053

Abstract

BACKGROUND/AIMS—The intestinal immune system faces large amounts of antigens, and its regulation is tightly balanced by cytokines. In this study, the effect of intestinal flow diversion on spontaneous secretion of interleukin (IL)-4 and interferon (IFN)- γ was analysed.
METHODS—Eight patients (two with Crohn's disease, four with ulcerative colitis, and two with previous colon cancer) carrying a double lumen small bowel stoma after a total colectomy procedure were included in the study. For each patient, eight biopsy samples were taken endoscopically from both the diverted and non-diverted part of the small bowel. Intraepithelial lymphocytes (IELs) and lamina propria lymphocytes (LPLs) were isolated separately and assayed for numbers of cells spontaneously secreting IL-4 and/or IFN-γ by an ELISPOT technique.
RESULTS—Compared with the non-diverted mucosa, a significant decrease in the number of spontaneously IFN-γ secreting CD3 lymphocytes was observed in the diverted small bowel mucosa among both IELs (p = 0.008) and LPLs (p = 0.007). The same results, although less significant, were obtained for IL-4, especially in LPLs (p = 0.01).
CONCLUSION—The intestinal content influences the spontaneous secretion of IFN-γ and IL-4 by intestinal lymphocytes. These results could help to elucidate the anti-inflammatory role of split ileostomy in patients suffering from inflammatory bowel diseases.


Keywords: intestine; T lymphocytes; mucosa; interleukin-4; interferon-γ; ELISPOT

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Figure 1  .

Figure 1  

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Numbers of cells spontaneously secreting interferon (IFN) γ or interleukin (IL) 4/106 intraepithelial lymphocytes (IELs) or lamina propria lymphocytes (LPLs) in diverted and non-diverted small bowel mucosa of patients with Crohn's disease or ulcerative colitis, or patients without inflammatory bowel disease (IBD). Results from the same patients are linked. The degree of significance was evaluated with the paired Wilcoxon test. SC, secreting cells.

Figure 2  .

Figure 2  

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Interferon (IFN) γ ELISPOT for intestinal lymphocytes from a patient with ulcerative colitis carrying a split ileostomy. Upper part: intraepithelial lymphocytes from non-diverted mucosa (A) representing 10 000 IFN-γ secreting cells per 106 CD3 T lymphocytes and from diverted mucosa (B) where no IFN-γ secreting cells could be observed. Lower part: lamina propria lymphocytes from non-diverted mucosa (C) representing 27 000 IFN-γ secreting cells per 106 CD3 T lymphocytes and from diverted mucosa (D) representing 124 IFN-γ secreting cells per 106 CD3 T lymphocytes.

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