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Fecal stream diversion and mucosal cytokine levels in collagenous colitis: A case report
Linköping University, Linköping, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0001-5460-8888
Linköping University, Linköping, Sweden .
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2015 (English)In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 21, no 19, 6065-6071 p.Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Pleasanton, USA: Baishideng Publishing Group Inc. , 2015. Vol. 21, no 19, 6065-6071 p.
National Category
Gastroenterology and Hepatology
Research subject
Immunology
Identifiers
URN: urn:nbn:se:oru:diva-55055ISI: 000355115600036PubMedID: 26019474Scopus ID: 2-s2.0-84929649035OAI: oai:DiVA.org:oru-55055DiVA: diva2:1069715
Note

Funding Agencies:

Abbott 

dr Falk Pharma 

Available from: 2017-01-30 Created: 2017-01-30 Last updated: 2017-02-01Bibliographically approved

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