Visualising E-selectin in the detection and evaluation of inflammatory bowel disease.
BACKGROUND
Vascular endothelial E-selectin expression is induced by proinflammatory cytokines and contributes to accumulation of leucocytes in tissues.


OBJECTIVE
To investigate the role of E-selectin in inflammatory bowel disease (IBD).


METHODS
E-selectin expression was assessed in patients with ulcerative colitis and Crohn's disease by measuring the concentration of circulating soluble E-selectin (sE-selectin) using ELISA, by immunohistochemistry of colonic biopsy specimens, and by abdominal immunoscintigraphy after injecting radiolabelled F(ab')2 fragment of a monoclonal anti-E-selectin antibody. The value of scintigraphy using anti-E-selectin was judged by a prospective comparative study of autologous leucocyte scanning and E-selectin antibody scanning in 17 patients with IBD.


RESULTS
Circulating sE-selectin was elevated in patients with clinically active disease. Tissue expression of E-selectin was enhanced in patients with active inflammation, with weak or absent expression in inactive disease and healthy controls. In-111 labelled anti-E-selectin scintiscans were compared with Tc-99m labelled leucocyte scans performed 24 hours earlier. Twelve patients had areas of active inflammation on leucocyte scan while 11 patients had positive E-selectin scans. The results of the two scans were concordant in 14 patients, with those positive for both (10/17) showing similar disease localisation and extent.


CONCLUSIONS
Tissue E-selectin and circulating sE-selectin are increased during active inflammatory bowel disease. Anti-E-selectin imaging with radiolabelled monoclonal antibody identified areas of inflammation in Crohn's disease and ulcerative colitis. The technique should prove useful clinically for identifying the site and extent of disease.
Gastroenterology Unit, Hammersmith Hospital, Royal Postgraduate Medical School, London, UK.
M
M
Bhatti
P
P
Chapman
M
M
Peters
D
D
Haskard
H J
HJ
Hodgson
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D003106:Colon / Q000000981:diagnostic imaging; D003424:Crohn Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D019040:E-Selectin / Q000032:analysis / Q000097:blood / Q000502:physiology*; D004730:Endothelium, Vascular / Q000737:chemistry; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
D000911:Antibodies, Monoclonal; D015415:Biomarkers; D019040:E-Selectin