Abstract
BACKGROUND—Excessive mucosal generation of cytokines and eicosanoids has been reported in vitro in ulcerative colitis (UC) using traumatising biopsy techniques, and in vivo using time consuming rectal dialysis. AIMS—To validate a simple filter paper technique to profile rectal mucosal production of cytokines and eicosanoids in vivo in patients with UC compared with controls. PATIENTS—Forty one patients with UC (21 with active disease) and 16 controls were studied. METHODS—In vitro, recovery of known concentrations of cytokine or mediator applied to filter papers was measured by ELISA following incubation in buffer. In vivo, patients and controls had filter papers apposed to the rectal mucosa briefly through a rigid sigmoidoscope. Filter papers were then incubated prior to assay by ELISA. RESULTS—In vitro validation studies showed that the filter paper technique could be used to measure mucosal release of interleukin-1β (IL-1β), tumour necrosis factor α (TNF-α), thromboxane B2 (TXB2), and prostaglandin E2 (PGE2), but not interferon γ (IFN-γ). Mucosal release of IL-1β, TNF-α, TXB2 and PGE2 were significantly increased in active UC (p=0.001) and correlated directly with disease activity (p=0.02). CONCLUSIONS—The filter paper technique confirmed increased rectal mucosal release of cytokines and eicosanoids in UC, in proportion to disease activity. The simplicity, safety and speed of the technique make it a practicable option for use in the outpatient clinic to study the pathogenesis of inflammatory bowel disease, and potentially its response to treatment. Keywords: cytokines; eicosanoids; ulcerative colitis; rectal dialysis
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Figure 1 .
Rectal mucosal release of interleukin 1β (IL-β), tumour necrosis factor α (TNF-α), thromboxane B2 (TXB2), and prostaglandin E2 (PGE2), measured by the filter paper technique in active ulcerative colitis (UC), inactive UC (defined by sigmoidoscopic score24) and in controls. Box and whisker plots are shown where the box is the interquartile range, the horizontal line the median, and the whiskers show the highest and lowest values. Numbers of patients studied are shown above the x axis. *p<0.0001, **p<0.001.
Figure 2 .
Correlation of measurements of rectal mucosal thromboxane (TXB2) release using the filter paper method and rectal dialysis. Two patients with active ulcerative colitis underwent the filter paper technique and two hour rectal dialysis on eight occasions. The x axis shows the values obtained by the filter paper method and the y axis the values obtained by rectal dialysis.
Selected References
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