Budesonide treatment of patients with collagenous colitis restores normal eosinophil and T-cell activity in the colon.
BACKGROUND
The aim of this study was to assess the activity of eosinophils, neutrophils, and CD4+ as well as CD8+ T-cells in 11 patients with active collagenous colitis (CC) before and after 8 weeks of budesonide treatment (9 mg once daily) compared to 10 healthy individuals.


METHODS
Clinical symptoms were recorded and intestinal biopsy samples were taken and analyzed by flow cytometry. Eosinophils with a high surface expression of CD44 and low CD9 expression were classified as activated. Neutrophil activity was assessed by their expression of CD66b, and CD69 was used as an activation marker for T-cells.


RESULTS
All patients responded to the treatment. The eosinophils in active CC showed increased activity compared to controls. The activity was back to control levels after treatment. Neutrophils were not activated in CC patients before or after treatment. CD8+ T-cells from untreated CC patients had a lower activity than controls, and a tendency of lower activity was observed on CD4+ T-cells. After treatment, the activity was increased on both types of T-cells and was not different from controls.


CONCLUSIONS
In the present study we demonstrated that the inflammation in CC is characterized by activated eosinophils but there is no neutrophil activity. CD4+ and CD8+ T-cells are increased in numbers in active CC but, surprisingly, they had a lower grade of activity than in control subjects. The major finding of this study is that budesonide treatment restores the normal activation of eosinophils and T-cells, accompanied by clinical remission.
Wagner
Michael
M
Department of Medical Sciences, Gastroenterology Research Group, University Hospital, Uppsala, Sweden. michael.wagner@akademiska.se
Lampinen
Maria
M
Sangfelt
Per
P
Agnarsdottir
Margret
M
Carlson
Marie
M
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015703:Antigens, CD / Q000378:metabolism; D000945:Antigens, Differentiation, T-Lymphocyte / Q000378:metabolism; D019819:Budesonide / Q000627:therapeutic use*; D046729:Colitis, Collagenous / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007124:Immunoenzyme Techniques; D037181:Lectins, C-Type / Q000378:metabolism; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation / Q000187:drug effects; D009504:Neutrophils / Q000187:drug effects* / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology*; D055815:Young Adult; D000099192:CD69 Antigens
D000893:Anti-Inflammatory Agents; D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D019819:Budesonide; D037181:Lectins, C-Type; D000099192:CD69 Antigens