Pouchitis aftertotal retocolectomy is one of the most common complication of patients withulcerative colitis (UC), while its frequency is quite rare in familial adenomatouspolyposis (FAP).
PURPOSE: To evaluate the inflammatory activity in endoscopicaly normalmucosa of the ileal pouch, by determining the expression of TNF-aand IL-1b, and the activation of NF-kB.
METHODS AND PATIENTS: Twenty patients with "J" pouch after total retocolectomywere studied, being 10 patients with UC and 10 with FAP. The control group wasconstituted by biopsies from terminal ileum take during normal colonoscopy examination.Biopsies from mucosa of the pouch and from normal ileum were done, and theywere snap-frozen in liquid nitrogen. The expression of TNF-aand IL-1b were analyzed by total extract, and NF-kBwas evaluated by immunoprecipitation and immunoblot.
RESULTS: Expression of TNF-a and IL-1bwas increased in patients with UC, when it was compared with FAP (p<0.05).Conversely, the expression of NF-kB was increasedin patients with UC, witch was not different from FAP. The control group hadlittle expression of TNF-a (p<0.01). The activationof NF-kB (p>0.1) and the expression of IL-1b(p>0.05) were similar, when comparing UC and FAP with control group.
CONCLUSION: The patients with UC presented increased levels of the studiedcytokines, even without clinic and endoscope evidence of pouchitis. These findingscould be a suggestion of higher susceptibility to this complication among patientswith UC.
