title: Are pANCA, ASCA, or cytokine gene polymorphisms associated with pouchitis? Long-term follow-up in 102 ulcerative colitis patients.
abstract: OBJECTIVE
  Pouchitis is the most frequent complication after ileal pouch-anal anastomosis for ulcerative colitis. This study aims to analyze the frequency and characteristics of pouchitis in long-term follow-up in a large population, and to determine whether a significant association exists between five immunogenetic markers and pouchitis.
  
  
  METHODS
  From a population of over 500 ulcerative colitis patients who had undergone ileal pouch-anal anastamosis 5-12 yr earlier, 102 subjects participated in the study. Using clinical data obtained from interviews and chart reviews, patients were classified into three groups: no pouchitis; 1-2 episodes per year; and >2 episodes per year. Coded sera from the patients were analyzed for ulcerative colitis-associated perinuclear antineutrophil cytoplasmic antibodies and Crohn's disease-associated anti-saccharomyces cerevesiae antibodies. Interleukin-1 receptor antagonist, tumor necrosis factor (TNF), and lymphotoxin beta (lymphotoxin) polymorphisms were also analyzed.
  
  
  RESULTS
  Pouchitis affected 49% of the study population. Antineutrophil cytoplasmic antibodies, anti-saccharomyces cerevesiae antibodies, and lymphotoxin-beta polymorphisms were not associated with pouchitis. Carriage of interleukin-1 receptor antagonist allele 2 was significantly greater among those without pouchitis than those with pouchitis. Patients without pouchitis had a significantly greater carriage rate of TNF allele 2.
  
  
  CONCLUSIONS
  Perinuclear antineutrophil cytoplasmic antibodies and anti-saccharomyces cerevesiae antibodies are not correlated with pouchitis, but interleukin-1 receptor antagonist and TNF may play a role in its development. Further evaluation of these markers in pouchitis will require larger populations, long-term prospective observation, and studies that correlate polymorphisms with specific immunologic functions.
authors.affiliation: Department of Gastroenterology, Mount Sinai Medical Center, New York, USA.
authors.forename: James
authors.initials: J
authors.lastname: Aisenberg
authors.forename: Peter E
authors.initials: PE
authors.lastname: Legnani
authors.forename: Naris
authors.initials: N
authors.lastname: Nilubol
authors.forename: Gena M
authors.initials: GM
authors.lastname: Cobrin
authors.forename: Sharif H
authors.initials: SH
authors.lastname: Ellozy
authors.forename: Refaat A F
authors.initials: RA
authors.lastname: Hegazi
authors.forename: Jessica
authors.initials: J
authors.lastname: Yager
authors.forename: Carol
authors.initials: C
authors.lastname: Bodian
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Gorfine
authors.forename: Joel J
authors.initials: JJ
authors.lastname: Bauer
authors.forename: Scott E
authors.initials: SE
authors.lastname: Plevy
authors.forename: David B
authors.initials: DB
authors.lastname: Sachar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000235:genetics*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000235:genetics*; D003093:Colitis, Ulcerative / Q000601:surgery*; D016207:Cytokines / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D019449:Pouchitis / Q000453:epidemiology / Q000235:genetics*; D015995:Prevalence; D012441:Saccharomyces cerevisiae / Q000276:immunology; D013997:Time Factors
chemical_list: D000906:Antibodies; D019268:Antibodies, Antineutrophil Cytoplasmic; D016207:Cytokines