Steroids reduce local inflammatory mediator secretion and mucosal permeability in collagenous colitis patients.
OBJECTIVE
To study the effect of oral steroids upon clinical response and rectal mucosa secretion of eosinophil cationic protein (ECP), myeloperoxidase (MPO), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and albumin in patients with collagenous colitis (CC).


METHODS
A segmental perfusion technique was used to collect perfusates from rectum of CC patients once before and twice (one and four weeks) after the start of steroid treatment. Clinical data was monitored and ECP, MPO, bFGF, VEGF and albumin concentrations were analyzed by immunochemical methods in perfusates and in serum.


RESULTS
Steroids reduced the number of bowel movements by more than five times within one week and all patients reported improved subjective well-being at wk 1 and 4. At the same time, the median concentrations of ECP, bFGF, VEGF and albumin in rectal perfusates decreased significantly. MPO values were above the detection limit in only 3 patients before treatment and in none during treatment. VEGF, bFGF, ECP and albumin concentrations correlated with each other with the exception of ECP and albumin. A decrease of serum ECP and VEGF concentrations was also seen even if the overtime reduction was not significant.


CONCLUSIONS
Oral steroid treatment in CC patients induced a simultaneous reduction of bowel movements and rectal release of ECP, bFGF, VEGF and albumin, suggesting that these polypeptides and increased mucosal permeability are important components of the pathophysiology in collagenous colitis.
Taha
Yesuf
Y
Departments of Medical Sciences, University Hospital, Uppsala, Sweden. yesuf.taha@medsci.uu.se
Raab
Yngve
Y
Carlson
Marie
M
Larsson
Anders
A
Lördal
Mikael
M
Lööf
Lars
L
Thörn
Magnus
M
D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D046729:Colitis, Collagenous / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D003106:Colon / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D047150:Eosinophil Cationic Protein / Q000378:metabolism*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects; D009195:Peroxidase / Q000378:metabolism; D013256:Steroids / Q000494:pharmacology* / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D000418:Albumins; D013256:Steroids; D042461:Vascular Endothelial Growth Factor A; D016222:Fibroblast Growth Factor 2; D009195:Peroxidase; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human