CD68 expression is markedly different in Crohn's disease and the colitis associated with chronic granulomatous disease.
BACKGROUND
Chronic granulomatous disease (CGD) is a rare inherited immunodeficiency disorder characterized by inability of phagocytes to kill certain bacteria and fungi. Histology from colon biopsies of CGD patients have shown the presence of inflammation and granulomas, almost indistinguishable from the findings seen in Crohn's disease. We sought to determine if there were any differences in the cell types that comprise the inflammatory infiltrates in inflamed colon specimens between the 2 diseases. The objective was to determine whether the pattern of inflammatory cell composition could be used to distinguish CGD-associated colitis from Crohn's colitis.


METHODS
Biopsies from 6 patients with Crohn's disease, 6 patients with CGD, and 6 control patients were stained with antibodies to CD3, CD4, CD8, CD68, CD79, CD163, and Foxp3. Positively staining cells per mm(2) of lamina propria were calculated for each antibody, with the exception of CD163, in which a percent area of lamina propria stained was calculated.


RESULTS
There was a marked difference in the average CD68+ cells per mm(2) of lamina propria between the 2 groups (Crohn's: 1104.2 cells/mm(2); CGD: 242.3 cells/mm(2), P < 0.0004) and a significant difference between the CGD group and control group (Control: 565.4 cells/mm(2), CGD: 242.3 cells/mm(2), P = 0.0072). There were no significant differences between Crohn's and CGD biopsies in the other cell types.


CONCLUSIONS
This phenomenon provides physicians with a simple and valuable tool to identify CGD in patients with colonic inflammation.
Liu
Steven
S
Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Russo
Pierre A
PA
Baldassano
Robert N
RN
Sullivan
Kathleen E
KE
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism*; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003092:Colitis / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D003424:Crohn Disease / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006105:Granulomatous Disease, Chronic / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008297:Male; D055815:Young Adult; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule