Complement activation capacity in plasma before and during high-dose prednisolone treatment and tapering in exacerbations of Crohn's disease and ulcerative colitis.
BACKGROUND
Ulcerative colitis (UC) and Crohn's disease (CD) are characterized by intestinal inflammation mainly caused by a disturbance in the balance between cytokines and increased complement (C) activation. Our aim was to evaluate possible associations between C activation capacity and prednisolone treatment.


METHODS
Plasma from patients with exacerbations of UC (n = 18) or CD (n = 18) were collected before and during high dose prednisolone treatment (1 mg/kg body weight) and tapering. Friedman's two way analysis of variance, Mann-Whitney U test and Wilcoxon signed-rank sum test were used


RESULTS
Before treatment, plasma from CD patients showed significant elevations in all C-mediated analyses compared to the values obtained from 38 healthy controls (p < 0.02), and in mannan binding lectin (MBL)-concentration and MBL-C4-activation capacity (AC) values compared to UC patients (p < 0.02). Before treatment, plasma from UC patients showed significant elevations only in the classical pathway-mediated C3-AC compared to values obtained from healthy controls (p < 0.01). After treatment was initiated, significant reductions, which persisted during follow-up, were observed in the classical pathway-mediated C3-AC and MBL-C4-AC in plasma from CD patients (p < 0.05).


CONCLUSIONS
Our findings indicate that C activation capacity is up-regulated significantly in plasma from CD patients. The decreases observed after prednisolone treatment reflect a general down-regulation in immune activation.
Zimmermann-Nielsen
Erik
E
Department of Surgery K, Hospital of Funen, Svendborg, Valdemarsgade 53, Denmark 5700 Svendborg. erzn.shf-post1@fyns-amt.dk
Grønbaek
Henning
H
Dahlerup
Jens Frederik
JF
Baatrup
Gunnar
G
Thorlacius-Ussing
Ole
O
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000097:blood* / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003167:Complement Activation / Q000187:drug effects*; D003424:Crohn Disease / Q000097:blood* / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007107:Immune System / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D011239:Prednisolone