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. 2001 Jun;48(6):792–796. doi: 10.1136/gut.48.6.792

Ulcer associated cell lineage glands expressing trefoil peptide genes are induced by chronic ulceration in ileal pouch mucosa

M Pera 1, J Heppell 1, R Poulsom 1, F Teixeira 1, J Williams 1
PMCID: PMC1728308  PMID: 11358897

Abstract

BACKGROUND—Chronic ulcerative conditions in the gastrointestinal tract result in the appearance of the ulcer associated cell lineage (UACL). The glands of this new cell lineage secrete epidermal growth factor, transforming growth factor α, and the trefoil factor family (TFF) peptides, which are known to participate in repair processes. Pouchitis is the most frequent complication of ileal pouch-anal anastomosis.
AIM—Our aim was to determine whether the mucosal ulceration present in pouchitis can induce the development of UACL glands.
METHODS—Biopsies from ileal pouches with pouchitis (n=10), healthy pouches (n=5), and normal terminal ileum (n=5) were studied. Expression of TFF mRNA was assessed by in situ hybridisation. TFF1 and TFF2 proteins were localised by immunochemistry.
RESULTS—UACL glands containing TFF1 and TFF2 were observed in six patients with pouchitis. In some glands, there was TFF3 mRNA as has been reported for Crohn's UACL. None of the biopsies from ileal reservoirs without pouchitis showed UACL glands (p<0.05). Neither TFF1 nor TFF2 expression was detected in ileal reservoirs without pouchitis.
CONCLUSION—UACL glands arise de novo in ileal pouch mucosa of patients with pouchitis and express all three TFF peptide genes. Chronic inflammation alone, present in healthy pouches, is not enough to stimulate the growth of the UACL, and additional stimuli consequent on ulceration may be needed.


Keywords: ulcer associated cell lineage; trefoil peptides; chronic ulceration; pouchitis

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Figure 1  .

Figure 1  

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Histological sections of ileal pouch mucosa stained with: (A) haematoxylin and eosin showing some inflammation and profiles of ulcer associated cell lineage (UACL) glands (asterisks); (B) diastase periodic acid-Schiff/alcian blue showing magenta neutral mucin UACL acinar and surface cell (arrow) compartments and alcian blue positive goblet cells; (C) trefoil factor family (TFF) 1 monoclonal antibody showing the presence of this peptide in UACL surface cells; (D) TFF2 monoclonal antibody showing the presence of this peptide in lower duct and acinar cells; (E, F) antisense TFF1 riboprobe showing the presence of TFF1 mRNA in UACL surface cells (arrow) but not acinar regions (asterisk) or goblet cells; (G, H) antisense TFF3 riboprobe showing the presence of TFF3 mRNA in both surface (arrow) and acinar (asterisk) regions of the UACL gland as well as in some goblet cells.

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