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Fecal stream diversion and mucosal cytokine levels in collagenous colitis: A case report
Linköping University, Linköping, Sweden.
Örebro universitet, Institutionen för hälsovetenskap och medicin.ORCID-id: 0000-0002-2244-9816
Örebro universitet, Institutionen för hälsovetenskap och medicin.ORCID-id: 0000-0001-5460-8888
Linköping University, Linköping, Sweden .
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2015 (engelsk)Inngår i: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 21, nr 19, s. 6065-6071Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

In this case report, we examined the levels of cytokines expressed before and during fecal stream diversion and after intestinal continuity was restored in a patient with collagenous colitis. We report the case of a 46-year-old woman with chronic, active collagenous colitis who either failed to achieve clinical remission or experienced adverse effects with the following drugs: loperamide, cholestyramine, budesonide, methotrexate and adalimumab. Due to the intractable nature of the disease and because the patient was having up to 15 watery bowel movements per day, she underwent a temporary ileostomy. Colonic biopsies were analyzed for mucosal cytokine protein levels before and during fecal stream diversion and after intestinal continuity was restored. Mucosal protein levels of interleukin (IL)-1β, IL-2, IL-6, IL-12, IL-17 A, IL-23, TNF, IFN-γ, IL-4, IL-5, IL-10 and IL-13 were all higher during active disease and decreased to non-detectable or considerably lower levels during fecal stream diversion. One month after the restoration of bowel continuity, when the patient experienced a relapse of symptoms, IL-2, IL-23 and IL-21 levels were again increased. Our results indicate that fecal stream diversion in this patient suppressed the levels of all cytokines analyzed in colonic biopsies. With the recurrence of clinical symptoms and histological changes after bowel reconstruction, the levels of primarily proinflammatory cytokines increased. Our findings support the hypothesis that a luminal factor triggers the inflammation observed in collagenous colitis.

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Pleasanton, USA: Baishideng Publishing Group Inc. , 2015. Vol. 21, nr 19, s. 6065-6071
HSV kategori
Forskningsprogram
Immunologi
Identifikatorer
URN: urn:nbn:se:oru:diva-55055ISI: 000355115600036PubMedID: 26019474Scopus ID: 2-s2.0-84929649035OAI: oai:DiVA.org:oru-55055DiVA, id: diva2:1069715
Merknad

Funding Agencies:

Abbott 

dr Falk Pharma 

Tilgjengelig fra: 2017-01-30 Laget: 2017-01-30 Sist oppdatert: 2019-03-26bibliografisk kontrollert

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Kumawat, Ashok KumarHultgren-Hörnquist, Elisabeth

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