title: Interleukin-18 is increased only in a minority of patients with active Crohn's disease.
abstract: OBJECTIVE
  It has been suggested that Crohn's Disease (CD) is associated with an elevated T helper 1 response as manifested by increased production of interleukin-18 (IL-18). Local concentrations of neutralizing IL-18 binding proteins (IL-18 bp) may counteract biological functions of mature IL-18 in mucosal inflammation. Therefore, we investigated the IL-18/IL-18 bp system in a large group of patients with active inflammatory bowel disease (IBD) to identify patients that could respond theoretically to IL-18 neutralizing treatment strategies.
  
  
  METHODS
  IL-18 and IL-18 bp messenger RNA (mRNA) expression in colonic mucosa from patients with active CD (n = 72), active ulcerative colitis (UC; n = 32), and non-IBD controls (infectious colitis or diverticulitis; n = 19) and normal, non-diseased controls (n = 20) were measured by reverse-transcribed real-time polymerase chain reaction. Mature IL-18 protein and IL-18 bp expression in inflamed mucosa were assessed by Western blotting.
  
  
  RESULTS
  Although IL-18 mRNA was increased in some patients with CD, the increase was not statistically significant. Densitometric evaluation of IL-18/alpha-actin ratio in patients with active CD (n = 20) and patients with UC (n = 10) demonstrated an increased ratio of IL-18 protein in CD when compared to UC (1.04 vs 0.72 [median]). On closer inspections, only 7/20 CD patients had an increased IL-18 protein expression in inflamed areas compared to noninflamed mucosa.
  
  
  CONCLUSIONS
  IL-18 expression in active CD is heterogeneous, only a minority of patients expresses elevated levels. Further treatment strategies targeting IL-18 expression in active CD should be concentrated on this subgroup of patients.
authors.affiliation: Department of Internal Medicine II, Saarland University, Homburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Schmidt
authors.forename: T
authors.initials: T
authors.lastname: Giese
authors.forename: R
authors.initials: R
authors.lastname: Goebel
authors.forename: M
authors.initials: M
authors.lastname: Schilling
authors.forename: T
authors.initials: T
authors.lastname: Marth
authors.forename: A
authors.initials: A
authors.lastname: Ruether
authors.forename: S
authors.initials: S
authors.lastname: Schreiber
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
authors.forename: S C
authors.initials: SC
authors.lastname: Meuer
authors.forename: A
authors.initials: A
authors.lastname: Stallmach
mesh_terms: D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000276:immunology* / Q000378:metabolism; D020382:Interleukin-18 / Q000096:biosynthesis* / Q000235:genetics; D007413:Intestinal Mucosa / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000032:analysis / Q000096:biosynthesis; D014158:Transcription, Genetic; D015854:Up-Regulation
chemical_list: D020382:Interleukin-18; D012333:RNA, Messenger