TGF-beta1 and IGF-1 production and recurrence of Crohn's disease after ileo-colonic resection.
BACKGROUND
Recurrence after surgery is a major problem in the treatment of Crohn's disease (CD). Alteration of healing processes may play a role in this phenomenon. Transforming growth factor beta (TGF-beta) and insulin-like growth factor (IGF-1) have pro-fibrogenic properties and are involved in wound-healing mechanisms. The aim of this study was to assess their role in the CD recurrence after ileo-colonic resection.


METHODS
Twenty patients with CD, who underwent ileo-colonic resection in the period between 1999 and 2005, were enrolled in this study. Tissue samples were obtained from macroscopically diseased and healthy ileum. The TGF-beta1 and IGF-1 mRNAs were quantified by real-time polymerase chain reaction using glyceraldehyde 3-phosphate dehydrogenase as the housekeeping gene. Histological severity of the disease was assessed to quantify the ileal inflammation. Patients' follow-up was investigated. Comparisons and correlations were carried out with nonparametric tests and survival analysis was performed.


RESULTS
Histological inflammation was moderately severe in the diseased bowel, while it was absent in healthy segments (P < 0.01). TGF-beta1 production in healthy bowels showed a direct correlation with clinical CD recurrence (tau = 0.43, P = 0.04) and survival analysis showed that patients who expressed high TGF-beta1 mRNA transcripts in healthy intestines had higher cumulative recurrence rates than those who expressed low TGF-beta1 mRNA levels (P = 0.02).


CONCLUSIONS
Our study suggests that the high levels of TGF-beta1 in healthy bowels of patients who undergo ileo-colonic resection for CD are associated with early clinical disease recurrence, while there seems to be no association between IGF-1 and CD recurrence.
Scarpa
Marco
M
Clinica Chirurgica I, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, University of Padova, Padova, Italy. marcoscarpa73@yahoo.it
Bortolami
Marina
M
Morgan
Susan L
SL
Kotsafti
Andromachi
A
Ferraro
Stefania
S
Ruffolo
Cesare
C
D'Incà
Renata
R
Polese
Lino
L
Barollo
Michela
M
D'Amico
Davide F
DF
Sturniolo
Giacomo C
GC
Angriman
Imerio
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000378:metabolism* / Q000601:surgery; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000378:metabolism*; D012008:Recurrence; D053773:Transforming Growth Factor beta1 / Q000378:metabolism*; D055815:Young Adult
D053773:Transforming Growth Factor beta1; D007334:Insulin-Like Growth Factor I