title: FK506-Binding Protein 5 mRNA Levels in Ileal Mucosa Are Associated with Pouchitis in Patients with Ulcerative Colitis.
abstract: BACKGROUND
  Although the pathogenesis of pouchitis is incompletely understood, steroid and FK506 therapy are significantly associated with pouchitis. These medical treatments are regulated by the FK506-binding protein (FKBP) 4 and FKBP5 genes.
  
  
  OBJECTIVE
  This study aimed to evaluate the relationship between pouchitis and FKBP4 and FKBP5 mRNA expression in ileal mucosa at the time of colectomy.
  
  
  METHODS
  Ileal mucosa specimens were collected from 71 patients who underwent ileal pouch-anal anastomosis for ulcerative colitis. FKBP4 and FKBP5 mRNA expression was evaluated. The relationship between mRNA expression and clinicopathological factors, including developed pouchitis, was investigated.
  
  
  RESULTS
  Of these 71 patients, 25 (35.2 %) patients developed pouchitis in a mean duration of 20.2 months (range 0-68 months). FKBP4 mRNA levels in patients who received an immunomodulator were significantly higher than those in untreated patients (0.167 ± 0.060 vs 0.131 ± 0.065, p = 0.009). However, FKBP5 mRNA levels in patients who received a three-stage operation were significantly lower than those in the other patients (1.97 ± 1.15 vs 2.70 ± 1.12, p = 0.02). A total dose of prednisolone >9.4 g (HR 2.84, p = 0.02) before colectomy and FKBP5 mRNA level higher than the median (HR 4.49, p = 0.01) were identified as factors related to pouchitis.
  
  
  CONCLUSIONS
  FKBP5 mRNA levels in ileal mucosa at the time of colectomy are significantly associated with pouchitis and may be a predictive factor for developing pouchitis.
authors.affiliation: Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan, taraki@clin.medic.mie-u.ac.jp.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.forename: Mikio
authors.initials: M
authors.lastname: Kawamura
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujikawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Toiyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001706:Biopsy; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000378:metabolism* / Q000601:surgery; D039021:Colonic Pouches; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007082:Ileum / Q000378:metabolism* / Q000601:surgery; D007413:Intestinal Mucosa / Q000378:metabolism / Q000601:surgery; D008297:Male; D019449:Pouchitis / Q000209:etiology* / Q000378:metabolism*; D011239:Prednisolone / Q000627:therapeutic use; D012333:RNA, Messenger / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D022021:Tacrolimus Binding Proteins / Q000378:metabolism*; D000099159:Tacrolimus Binding Protein 5
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone; D012333:RNA, Messenger; D022021:Tacrolimus Binding Proteins; D000099159:Tacrolimus Binding Protein 5