title: Low ileal interleukin 10 concentrations are predictive of endoscopic recurrence in patients with Crohn's disease.
abstract: BACKGROUND
  Endoscopic recurrence after surgery in Crohn's disease is frequent and unpredictable. Abnormal intestinal production of pro- (interleukin (IL)-1 beta, tumour necrosis factor alpha (TNF-alpha)) and anti- (IL-10) inflammatory cytokines has been associated with severe outcome in experimental models of colitis.
  
  
  METHODS
  We evaluated if ileal TNF-alpha, IL-1 beta, or IL-10 mRNA levels measured at the time of surgery predict endoscopic recurrence, and if ileal IL-10 levels are associated with particular IL-10 promoter alleles. Ileal biopsies were obtained peroperatively from the healthy neoileum of patients undergoing a right ileocolectomy for Crohn's disease. Mucosal TNF-alpha, IL-1 beta, and IL-10 mRNA levels were quantified by competitive polymerase chain reaction. A cut off value was determined using a receiver operating curve. IL-10.G promoter haplotypes were analysed using a polymorphic dinucleotide repeat in the IL-10 promoter region.
  
  
  RESULTS
  Three months after surgery, 53% of patients had endoscopic recurrence while 47% remained free of disease. The risk of endoscopic recurrence correlated with ileal IL-10 mRNA concentrations (r(2)=0.81). Endoscopic recurrence occurred more frequently in patients classified as low IL-10 producers than in those that were high producers (80% v 40%) (p=0.02). Patients with at least one of the two alleles G7-8 or G10-13 produced, respectively, higher (p=0.006) and lower (p=0.029) ileal IL-10 mRNA. The distribution of IL-10.G microsatellite genotypes was similar in patients with or without endoscopic recurrence.
  
  
  CONCLUSIONS
  Low ileal IL-10 mRNA concentration is a good marker of endoscopic recurrence in Crohn's disease but the distribution of IL-10.G haplotypes cannot predict the postoperative evolution of the disease.
authors.affiliation: Equipe Propre Institut National de la Santé et de la Recherche Médical 0114 sur la Physiopathologie des Maladies Inflammatoires Intestinales, CHU Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Meresse
authors.forename: P
authors.initials: P
authors.lastname: Rutgeerts
authors.forename: H
authors.initials: H
authors.lastname: Malchow
authors.forename: S
authors.initials: S
authors.lastname: Dubucquoi
authors.forename: J P
authors.initials: JP
authors.lastname: Dessaint
authors.forename: M
authors.initials: M
authors.lastname: Cohard
authors.forename: J F
authors.initials: JF
authors.lastname: Colombel
authors.forename: P
authors.initials: P
authors.lastname: Desreumaux
mesh_terms: D000328:Adult; D000483:Alleles; D000704:Analysis of Variance; D003424:Crohn Disease / Q000378:metabolism*; D005260:Female; D006239:Haplotypes; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis*; D016753:Interleukin-10 / Q000032:analysis*; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D018895:Microsatellite Repeats; D011237:Predictive Value of Tests; D011401:Promoter Regions, Genetic; D012333:RNA, Messenger / Q000032:analysis; D012372:ROC Curve; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D007375:Interleukin-1; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10