title: Tumour necrosis factor alpha and interleukin 1beta in relapse of Crohn's disease.
abstract: BACKGROUND
  Concentrations of proinflammatory cytokines are increased in the intestinal mucosa of patients with active Crohn's disease. Experimental immunotherapeutic interventions with anticytokine agents in refractory Crohn's disease show that tumour necrosis factor alpha (TNF alpha) may be an important mediator of inflammation. We investigated the relation between production of TNF alpha and interleukin 1beta by mononuclear cells of the colonic lamina propria in patients with remitting Crohn's disease and the risk of relapse.
  
  
  METHODS
  We followed up 137 patients with Crohn's disease in steroid-induced remission for 1 year. Secretion of proinflammatory cytokines (tumour necrosis factor alpha [TNF alpha] and interleukin 1beta) was assessed after short-term culture of human lamina propria mononuclear cells.
  
  
  RESULTS
  Increased secretion of TNF alpha and interleukin 1beta were predictive for acute relapses within the next year. Site and extent of disease, baseline demographics, and serum acute-phase proteins had little predictive value.
  
  
  CONCLUSIONS
  TNF alpha is important as a target molecule for immune interventions in Crohn's disease. The capacity to produce TNF alpha or interleukin 1beta may identify patients who would benefit from anti-inflammatory remission maintenance.
authors.affiliation: 1st Medical Department, Christian Albrechts University, Kiel, Germany. s.schreiber@mucosa.de
authors.forename: S
authors.initials: S
authors.lastname: Schreiber
authors.forename: S
authors.initials: S
authors.lastname: Nikolaus
authors.forename: J
authors.initials: J
authors.lastname: Hampe
authors.forename: J
authors.initials: J
authors.lastname: Hämling
authors.forename: I
authors.initials: I
authors.lastname: Koop
authors.forename: B
authors.initials: B
authors.lastname: Groessner
authors.forename: H
authors.initials: H
authors.lastname: Lochs
authors.forename: A
authors.initials: A
authors.lastname: Raedler
mesh_terms: D015415:Biomarkers / Q000032:analysis; D002478:Cells, Cultured; D003106:Colon / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D007375:Interleukin-1 / Q000378:metabolism*; D012008:Recurrence; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*