Are pANCA, ASCA, or cytokine gene polymorphisms associated with pouchitis? Long-term follow-up in 102 ulcerative colitis patients.
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.
Aisenberg
James
J
Department of Gastroenterology, Mount Sinai Medical Center, New York, USA.
Legnani
Peter E
PE
Nilubol
Naris
N
Cobrin
Gena M
GM
Ellozy
Sharif H
SH
Hegazi
Refaat A F
RA
Yager
Jessica
J
Bodian
Carol
C
Gorfine
Stephen R
SR
Bauer
Joel J
JJ
Plevy
Scott E
SE
Sachar
David B
DB
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
D000906:Antibodies; D019268:Antibodies, Antineutrophil Cytoplasmic; D016207:Cytokines