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Published in: Journal of Gastrointestinal Surgery 11/2008

01-11-2008 | ssat poster presentation

TGF-β1 and IGF-1 and Anastomotic Recurrence of Crohn’s Disease After Ileo-Colonic Resection

Authors: Marco Scarpa, Marina Bortolami, Susan L. Morgan, Andromachi Kotsafti, Cesare Ruffolo, Renata D’Incà, Eugenia Bertin, Lino Polese, Davide F. D’Amico, Giacomo C. Sturniolo, Imerio Angriman

Published in: Journal of Gastrointestinal Surgery | Issue 11/2008

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Abstract

Background

After bowel resection, Crohn’s disease (CD) recurs frequently in the site of the anastomosis. Alteration of normal healing processes may play a role in this phenomenon. Transforming growth factor beta (TGF-β) and insulin-like growth factor (IGF-1) are involved in wound healing mechanisms with pro-fibrogenic properties. The aim of this study was to assess the expression of TGF-β1 and insulin-like growth factor 1 (IGF-1) in the different zones of the bowel wall to understand why side-to-side anastomosis are associated to a lower recurrence rate compared to end-to-end ones.

Patients and Methods

Seventeen patients affected by CD who underwent ileo-colonic resection from 2004 to 2005 were enrolled in this study. Full-thickness tissue samples were obtained from the mesenteric, the lateral, and the anti-mesenteric sides of the macroscopically diseased and healthy ileum for each patient. TGF-β1 and IGF-1 messenger RNAs (mRNAs) were quantified by real-time polymerase chain reaction. Myeloperoxidase activity and histological disease activity were assessed to quantify the ileal inflammation. Vimentin, desmin, and α-smooth muscle actin were stained with immunohistochemistry to assess the fibroblast, smooth muscle cell, and myofibroblasts populations. Comparisons and correlations were carried out with nonparametric tests.

Results

In diseased ileum, TGF-β1 mRNA transcripts in the antimesenteric side were significantly lower than those of the mesenteric side (p = 0.05), and a significant correlation between TGFβ-1 levels in diseased bowel and the sampling site was observed (τ = 0.36, p = 0.03). On the contrary, neither the IGF-1 mRNA transcripts nor the distribution of fibroblast, smooth muscle cell, and myofibroblasts populations showed any relation with the sampling site.

Conclusion

TGF-β1 mRNA expression was lower in the anti-mesenteric side of the diseased ileum, and this was consistent with the success of side-to-side anastomosis in preventing CD recurrence. Since high expression of TGF-β1 was associated to early recurrence, it seems rationale to construct the anastomosis on the anti-mesenteric side of the bowel.
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Metadata
Title
TGF-β1 and IGF-1 and Anastomotic Recurrence of Crohn’s Disease After Ileo-Colonic Resection
Authors
Marco Scarpa
Marina Bortolami
Susan L. Morgan
Andromachi Kotsafti
Cesare Ruffolo
Renata D’Incà
Eugenia Bertin
Lino Polese
Davide F. D’Amico
Giacomo C. Sturniolo
Imerio Angriman
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 11/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-008-0641-5

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