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International Journal of Colorectal Disease

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01-10-2009 | Original Article

Inflamed pouch mucosa possesses altered tight junctions indicating recurrence of inflammatory bowel disease

Authors: Salah Amasheh, Sonja Dullat, Michael Fromm, Jörg D. Schulzke, Heinz J. Buhr, Anton J. Kroesen

Published in: International Journal of Colorectal Disease | Issue 10/2009

Abstract

Background and aims

The etiology of pouchitis after coloproctomucosectomy with ileal pouch-anal anastomosis in patients with ulcerative colitis is still unknown. Beside changes in luminal antigens, the immunological predisposition is assumed to be responsible. In previous electrophysiological studies, we showed that mucosal barrier and transport function in pouchitis is markedly reduced. Thus, the aim of the present study was to analyze barrier function on the molecular level.

Material and methods

Pouch biopsies of 36 ulcerative colitis patients were analyzed. Time points were (1) intraoperative immediately prior to ileal pouch-anal anastomosis (n = 13), (2) >1 year after ileostomy closure (pouch, n = 12), and (3) during pouchitis (n = 11). Control terminal ileum biopsies were obtained from eight patients undergoing hemicolectomy due to carcinoma. Expression of tight junction proteins was analyzed by Western blotting and confocal laser-scanning microscopy. To elucidate effects on epithelial barrier properties, impedance spectroscopy was performed in miniaturized Ussing chambers.

Results

In pouchitis, epithelial resistance was markedly reduced compared to non-inflamed pouch and control ileum. Expression of tight junction proteins claudin-1, 3, 4, 5, and 7 and occludin revealed differential expression regulation with the tightening tight junction protein claudin-1 being decreased and an increase of the pore-forming claudin-2, whereas other claudins remained constant. Morphometry indicated the mucosal surface to be unchanged.

Conclusion

Pouchitis is characterized by a selective change of tight junction proteins in favor of opening the epithelial tight junction and, thus, the paracellular pathway, which contributes to the inflammatory process. This resembles changes in inflammatory bowel disease (IBD) and indicates IBD recurrence in pouchitis.

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Title: Inflamed pouch mucosa possesses altered tight junctions indicating recurrence of inflammatory bowel disease
Authors: Salah Amasheh
Sonja Dullat
Michael Fromm
Jörg D. Schulzke
Heinz J. Buhr
Anton J. Kroesen
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 10/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-009-0737-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inflamed pouch mucosa possesses altered tight junctions indicating recurrence of inflammatory bowel disease

Abstract

Background and aims

Material and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Material and methods

Results

Conclusion

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