Significance of systemic endotoxaemia in inflammatory bowel disease
Quantitative and qualitative disturbances in faecal flora suggest a role for enteric bacteria and their products in the pathogenesis of inflammatory bowel disease (IBD). This study investigated the hypothesis that systemically circulating endotoxins are of pathogenic significance in IBD by measuring...
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Published in | Gut Vol. 36; no. 6; pp. 897 - 901 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.06.1995
BMJ BMJ Publishing Group LTD |
Subjects | |
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Abstract | Quantitative and qualitative disturbances in faecal flora suggest a role for enteric bacteria and their products in the pathogenesis of inflammatory bowel disease (IBD). This study investigated the hypothesis that systemically circulating endotoxins are of pathogenic significance in IBD by measuring antibody, cytokine, and acute phase protein responses. Systemic endotoxaemia was found in 88% patients with ulcerative colitis (n = 25) and 94% with Crohn's disease (n = 31) during clinical relapse. Systemic endotoxaemia correlated positively with anatomic extent and clinical activity of ulcerative colitis. Circulating tumour necrosis factor (TNF) was detected in 40% of patients with ulcerative colitis and 45% with Crohn's disease. Plasma TNF concentrations correlated with clinical and laboratory measures of disease activity and were associated with a surgical outcome to the disease episode. Plasma soluble TNF receptor p55 concentration correlated positively with disease activity and endotoxin core antibody concentrations. Plasma IgG endotoxin core antibody concentrations were significantly increased in patients with Crohn's disease and correlated with systemic endotoxaemia. The presence of systemic endotoxaemia, its correlation with disease activity, disease extent, and endotoxin core antibody concentration and the detection of circulating TNF and soluble TNF receptors all support a pathogenic role for endotoxins in IBD. |
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AbstractList | Quantitative and qualitative disturbances in faecal flora suggest a role for enteric bacteria and their products in the pathogenesis of inflammatory bowel disease (IBD). This study investigated the hypothesis that systemically circulating endotoxins are of pathogenic significance in IBD by measuring antibody, cytokine, and acute phase protein responses. Systemic endotoxaemia was found in 88% patients with ulcerative colitis (n = 25) and 94% with Crohn's disease (n = 31) during clinical relapse. Systemic endotoxaemia correlated positively with anatomic extent and clinical activity of ulcerative colitis. Circulating tumour necrosis factor (TNF) was detected in 40% of patients with ulcerative colitis and 45% with Crohn's disease. Plasma TNF concentrations correlated with clinical and laboratory measures of disease activity and were associated with a surgical outcome to the disease episode. Plasma soluble TNF receptor p55 concentration correlated positively with disease activity and endotoxin core antibody concentrations. Plasma IgG endotoxin core antibody concentrations were significantly increased in patients with Crohn's disease and correlated with systemic endotoxaemia. The presence of systemic endotoxaemia, its correlation with disease activity, disease extent, and endotoxin core antibody concentration and the detection of circulating TNF and soluble TNF receptors all support a pathogenic role for endotoxins in IBD. |
Author | Barclay, G R Gardiner, K R Milne, L Stephens, S Brown, D Maxwell, R J Rowlands, B J Halliday, M I |
AuthorAffiliation | Department of Surgery, Queen's University of Belfast, Northern Ireland |
AuthorAffiliation_xml | – name: Department of Surgery, Queen's University of Belfast, Northern Ireland |
Author_xml | – sequence: 1 givenname: K R surname: Gardiner fullname: Gardiner, K R – sequence: 2 givenname: M I surname: Halliday fullname: Halliday, M I – sequence: 3 givenname: G R surname: Barclay fullname: Barclay, G R – sequence: 4 givenname: L surname: Milne fullname: Milne, L – sequence: 5 givenname: D surname: Brown fullname: Brown, D – sequence: 6 givenname: S surname: Stephens fullname: Stephens, S – sequence: 7 givenname: R J surname: Maxwell fullname: Maxwell, R J – sequence: 8 givenname: B J surname: Rowlands fullname: Rowlands, B J |
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Keywords | Human Immune response Pathogenesis Cytokine Systemic Endotoxin Inflammatory disease Crohn disease Tumor necrosis factor Digestive diseases Intestinal disease Endotoxemia Macrophage Ulcerative colitis |
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SubjectTerms | Adolescent Adult Aged Antibodies, Bacterial - blood Biological and medical sciences Colitis - blood Colitis, Ulcerative - blood Crohn Disease - blood Endotoxins - blood Endotoxins - immunology Female Gastroenterology. Liver. Pancreas. Abdomen Humans Immunoglobulin G - blood Inflammatory Bowel Diseases - blood Inflammatory Bowel Diseases - drug therapy Inflammatory Bowel Diseases - pathology Male Medical sciences Middle Aged Other diseases. Semiology Receptors, Tumor Necrosis Factor - analysis Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Tumor Necrosis Factor-alpha - analysis |
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