INCREASED LUMINAL RELEASE OF HYALURONAN IN UNINVOLVED JEJUNUM IN ACTIVE CROHNS-DISEASE BUT NOT IN INACTIVE DISEASE OR IN RELATIVES
INCREASED LUMINAL RELEASE OF HYALURONAN IN UNINVOLVED JEJUNUM IN ACTIVE CROHNS-DISEASE BUT NOT IN INACTIVE DISEASE OR IN RELATIVES
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DOI：
10.1159/000200932
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发表时间：
1992-01-01
期刊：
影响因子：
3.2
通讯作者：
GERDIN, B
中科院分区：
文献类型：
--
作者：
AHRENSTEDT, O;KNUTSON, L;GERDIN, B
最近获得的资料表明，在克罗恩病（CD）中，明显未受累的肠粘膜存在亚临床炎症活动。由于CD的特征是结缔组织和纤维化的激活，我们研究了透明质酸（HA）在多大程度上被释放到CD患者和亲属的孤立空肠段的管腔中，透明质酸是结缔组织的重要成分。回肠末端活动性CD患者（CD活动指数，CDAI, > 150; n = 14）， CD缓解期患者（CDAI < 150 n = 10）。CD患者的一级亲属（n = 21）和健康对照（n = 43）用导管进行口腔插管，允许对近端空肠的一段进行封堵和灌注。回肠末端活动性CD患者空肠液HA浓度为65 +/- 45马克杯/升，显著高于43名健康对照（42 +/- 23马克杯/升，p < 0.05），缓解期患者空肠液HA浓度为42 +/- 23马克杯/升，CD患者一级亲属空肠HA浓度为53 +/- 52马克杯/升，与对照组相比无升高。为了在组织中定位HA，手术期间对CD患者和对照组进行了小肠活检，并对HA进行了亲和染色。在乳糜泻患者和对照组的活检中，绒毛固有层可见强烈的HA染色，但上皮未见染色。腔内释放增加很可能反映了CD中绒毛易感性增加和裸露固有层暴露于腔内，可能与局部合成增加相结合。
Recently obtained data suggest that there is a subclinic inflammatory activity in the apparently uninvolved intestinal mucosa in Crohn's disease (CD). As CD is characterized by an activation of connective tissue and fibrosis, we investigated the extent to which hyaluronan (HA), an essential component of the connective tissue, was released into the lumen of an isolated jejunal segment in CD patients and in relatives. Patients with active CD of the terminal ileum (CD activity index, CDAI, > 150; n = 14), patients with CD in remission (CDAI < 150 n = 10). first-degree relatives of the CD patients (n = 21) and healthy controls (n = 43) were orally intubated with a catheter allowing occlusion and perfusion of a segment of the proximal jejunum. The jejunal fluid concentration of HA was 65 +/- 45 mug/l in patients with active CD in the terminal ileum, significantly higher than the value for 43 healthy controls (42 +/- 23 mug/l; p < 0.05), and the corresponding values for patients in remission (42 +/- 23 mug/l) and for first-degree relatives of the CD patients (53 +/- 52 mug/l), were not increased compared to the control group. To localize HA in the tissue, small bowel biopsies were taken during surgery from patients with CD and from controls and affinity stained for HA. There was an intense staining for HA in the lamina propria of the villi, both in biopsies from patients with CD and from controls, but no staining in the epithelium. An increased luminal release most likely reflects an increased villous vulnerability and exposure of naked lamina propria to the lumen in CD, possibly in combination with an increased local synthesis.