[Analysis of enteral nervous system in children with drug resistant ulcerative colitis].
BACKGROUND
pathogenesis of inflammatory bowel diseases has been intensively investigated for many years. The role of enteric nervous system (ENS) and neuroprotective transmitters such as galanine (GAL), vasoactive intestinal peptide (VIP) and pituitary adenosine cyclase activating peptide (PACAP) has been underlined recently. Neuroprotective transmitters play a role in the regulation of intestinal contractions, ion transport in the intestinal epithelium and modulation of the proinflammatory cytokine production, which may result in diminuation of inflammation.


OBJECTIVE
was to investigate activity of ENS in children with drug resistant ulcerative colitis measured by the density of GAL, VIP and/or PACAP containing nervous fibres in mucosal membrane in course of pharmacological treatment and 12 months after colectomy.


METHODS
16 children were included in the study. Group I consisted of 7 children with drug resistant ulcerative colitis. Mucosal biopsy specimen was taken twice: colonoscopy before colectomy during (12 months earlier on average) and from resected colon. Group II (reference group) consisted of 9 children with excluded inflammatory bowel diseases based on colonoscopy and biopsy mucosal specimen assessment. Histology and immunochemistry of mucosal samples were analysed.


RESULTS
decreased density of GAL, VIP and/or PACAP containing nervous fibres in colon mucosal membrane of children with ulcerative colitis was found: GAL-IR (3.5 +/- 3.15), VIP-IR (19.7 +/- 2.7), PACAP-IR (6.3+/-2.52) as compared to the reference group: GAL-IR (11.2+/-5.58), VIP-IR (36.1 +/- 16.0) and PACAP-IR (15.7 +/- 9.95). Significant diminuation of the density of GAL, VIP and/or PACAP containing nervous fibres was found in the study.


CONCLUSIONS
1. The density of VIP, PACAP and GAL containing nerve fibres diminishes in the course of ulcerative colitis, which may be a result of progressive degradation of colon mucosal membrane. 2. The hypothesis that absence of chemotaxis inhibition by low levels of neuroprotective transmitters might be a reason for drug resistance in ulcerative colitis.
Kamińska
Barbara
B
Katedra i Klinika Pediatrii, Gastroenterologii i Onkologii Dzieciecej, Akademia Medyczna, ul. Nowe Ogrody 1-6, 80-803 Gdańsk, Poland. bkam@amg.gda.pl
Landowski
Piotr
P
Gonkowski
Sławomir
S
Szlagatys-Sidorkiewicz
Agnieszka
A
Majewski
Mariusz
M
Dobosz
Marek
M
Ismail
Hor
H
Korzon
Maria
M
D000293:Adolescent; D001706:Biopsy; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D003106:Colon / Q000294:innervation* / Q000473:pathology; D003113:Colonoscopy; D015536:Down-Regulation; D004351:Drug Resistance; D017615:Enteric Nervous System / Q000378:metabolism / Q000473:pathology; D005260:Female; D019004:Galanin / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000294:innervation / Q000378:metabolism* / Q000473:pathology; D008297:Male; D009411:Nerve Endings / Q000473:pathology; D018696:Neuroprotective Agents / Q000627:therapeutic use; D051219:Pituitary Adenylate Cyclase-Activating Polypeptide / Q000032:analysis; D014660:Vasoactive Intestinal Peptide / Q000032:analysis
D018696:Neuroprotective Agents; D051219:Pituitary Adenylate Cyclase-Activating Polypeptide; D014660:Vasoactive Intestinal Peptide; D019004:Galanin