title: Mucosal proinflammatory cytokine and chemokine expression of gastroduodenal lesions in Crohn's disease.
abstract: BACKGROUND
  The stomach and the duodenum are frequent sites of involvement by diminutive lesions in Crohn's disease (CD).
  
  
  OBJECTIVE
  To assess mucosal proinflammatory cytokines and chemokines in gastroduodenal lesions of CD.
  
  
  METHODS
  13C-Urea breath test and upper endoscopy were performed in 29 CD patients and seven control subjects, and biopsy specimens were obtained from the gastric cardia and the duodenum. Histology and mucosal levels of IL-1beta, IL-8/CXCL8 and RANTES/CCL5 were assessed and compared according to the presence of gastric cardial lesion [bamboo joint-like appearance (BJA)] and duodenal lesion (notched appearance, aphthous erosion and polypoid lesion). In 11 CD patients, these procedures were repeatedly performed after administration of famotidine.
  
  
  RESULTS
  H. pylori was less frequently positive in CD patients than in controls (10% vs. 71%, P = 0.003). Prevalence of cardial and duodenal lesion was significantly higher in CD than in controls (59% vs. 0%, P = 0.008 for gastric lesion; 45% vs. 0%, P = 0.034 for duodenal lesion). There were no differences in IL-1beta, IL-8 and RANTES between CD and controls. Duodenal mucosal IL-1beta and IL-8 were significantly higher in positive duodenal lesion than in negative duodenal lesion. However, there were no such differences with respect to cardial lesions. Endoscopic findings remained unchanged after administration of famotidine, while there was a trend towards decreases in IL-1beta and IL-8 in the gastric cardia.
  
  
  CONCLUSIONS
  The pathogenesis of diminutive lesions of CD may be different between the stomach and the duodenum. Famotidine may not have a therapeutic effect on duodenal lesion in CD.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi, Fukuoka, Japan. morimori@intmed2.med.kyushu-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Moriyama
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Y
authors.initials: Y
authors.lastname: Jo
authors.forename: S
authors.initials: S
authors.lastname: Yada
authors.forename: M
authors.initials: M
authors.lastname: Hirahashi
authors.forename: T
authors.initials: T
authors.lastname: Yao
authors.forename: M
authors.initials: M
authors.lastname: Iida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D018925:Chemokines / Q000378:metabolism; D003424:Crohn Disease / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism*; D004382:Duodenitis / Q000378:metabolism* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005756:Gastritis / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D000897:Anti-Ulcer Agents; D018925:Chemokines; D016207:Cytokines; D015738:Famotidine