title: Depression and mucosal proinflammatory cytokines are associated in patients with ulcerative colitis and pouchitis - A pilot study.
abstract: OBJECTIVE
  Recent studies demonstrated that depression was associated with mucosal inflammation in patients with ulcerative colitis (UC). This association had not been studied in patients with UC with ileal pouch-anal anastomosis (IPAA) after restorative proctocolectomy. We hypothesized that depression and mucosal proinflammatory cytokines in UC-patients with pouchitis were associated.
  
  
  METHODS
  We assessed 18 IPAA-UC-patients with pouchitis and 19 IPAA-UC-patients without pouchitis. Mucosal biopsies were taken from the areas with maximal inflammation in the pouch or from the posterior wall of the pouch if the pouch had a normal endoscopic appearance. Disease activity was assessed by the Pouch Disease Activity Index. The expression of mucosal proinflammatory gene transcripts (interleukin-8 [IL-8] and interleukin-1ß [IL-1b]) was quantified by real-time polymerase chain reaction. Depression was assessed by the Hospital Anxiety and Depression Scale (HADS). Pearson correlations between depression and cytokine transcripts were calculated.
  
  
  RESULTS
  The correlation of HADS depression scores of patients with pouchitis with IL-8 was r=0.51 (p=0.03) and with IL-1ß was r=0.47 (p=0.04). The correlation between the HADS depression scores of patients without pouchitis with IL-8 was r=-0.19; (p=0.21) and with IL-1ß was r=-0.12 (p=0.30).
  
  
  CONCLUSIONS
  Depression is associated with mucosal proinflammatory cytokines in patients with pouchitis after restorative proctocolectomy in patients with UC.
authors.affiliation: Department Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser
authors.forename: Carsten
authors.initials: C
authors.lastname: Schmidt
authors.forename: Andreas
authors.initials: A
authors.lastname: Stallmach
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000096:biosynthesis*; D016209:Interleukin-8 / Q000096:biosynthesis*; D007413:Intestinal Mucosa / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D019449:Pouchitis / Q000150:complications* / Q000378:metabolism; D016737:Proctocolectomy, Restorative; D011795:Surveys and Questionnaires
chemical_list: D053583:Interleukin-1beta; D016209:Interleukin-8