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Clinical and Experi...
Clinical and Experimental Studies on Inflammatory Bowel Disease with special emphasis on Collagenous Colitis
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- Wagner, Michael, 1957- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Gastroenterology research group
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- Carlson, Marie, Associate Professor (thesis advisor)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Lampinen, Maria, Ph D (thesis advisor)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Sangfelt, Per, Associate Professor (thesis advisor)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Hertervig, Erik, Associate Professor (opponent)
- Lunds Univesitet. Inst för gastroenterologi och nutrition, Universitetssjukhuset i Lund
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(creator_code:org_t)
- ISBN 9789155478179
- Uppsala : Acta Universitatis Upsaliensis, 2010
- English 75 s.
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Series: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 565
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Abstract
Subject headings
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- This thesis describes studies in patients with inflammatory bowel disease (IBD) and collagenous colitis (CC). We investigated mucosal eosinophil and neutrophil granulocytes and T-cells involved in the inflammatory processes and aimed at determining whether these processes are reflected in the faecal (F) contents of specific proteins secreted by cells in the intestinal mucosa. Thus, we measured eosinophil cationic protein (ECP) and eosinophil protein X (EPX) and the neutrophil derived myeloperoxidase (MPO) and calprotectin (C); and in addition, chromogranin A (CgA), Chromogranin B (CgB) and secretoneurin (SN), derived from EEC cells and cells in the enteric nervous system. We found that a normalised FC level can serve as a surrogate marker for successful treatment in patients with IBD, but persistently high FC levels need further evaluation (study I). Furthermore, FC and F-MPO appear to relate better than F-EPX to treatment outcome in IBD. We evaluated F-ECP, F-EPX, F-MPO and FC as markers of disease activity and treatment outcome in patients with CC (study III) and concluded that F-ECP was the best discriminator of detecting active CC. Normalised F-ECP and F-EPX could serve as markers of successful treatment. We showed that the inflammation in CC is characterised by activated eosinophils, but that there is no neutrophil activity (study II). T-cells have a lower grade of activity in active CC than in control subjects. During budesonide treatment the normal activation of eosinophils and T-cells is restored, with concomitant clinical remission. The findings in studies II and III indicate that the eosinophils have an essential role in the pathophysiology of CC. Markedly higher values of F-CgA, F-CgB and F-SN were found in patients with CC than in those with IBD and controls (study IV) indicating a crucial role for the intestinal neuro-endocrine system in the pathogenesis of collagenous colitis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- Collagenous colitis
- inflammatory bowel disease
- ulcerative colitis
- Crohn´s disease
- faecal markers
- eosinophil
- T-cells
- ECP
- EPX
- MPO
- calprotectin
- flowcytometry
- chromogranin A
- chromogranin B
- secretoneurin
- budesonide
- Gastroenterology
- Gastroenterologi
- Medicin
- Medicine
Publication and Content Type
- vet (subject category)
- dok (subject category)
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Wagner, Michael, ...
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Carlson, Marie, ...
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Lampinen, Maria, ...
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Sangfelt, Per, A ...
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Hertervig, Erik, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Gastroenterology ...
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Uppsala University