SUBSTANCE-P - AN UNDERLYING FACTOR FOR POUCHITIS - PROSPECTIVE-STUDY OF SUBSTANCE P-IMMUNOREACTIVE AND VASOACTIVE INTESTINAL POLYPEPTIDE-IMMUNOREACTIVE INNERVATION AND MAST-CELLS
U. Keranen et al., SUBSTANCE-P - AN UNDERLYING FACTOR FOR POUCHITIS - PROSPECTIVE-STUDY OF SUBSTANCE P-IMMUNOREACTIVE AND VASOACTIVE INTESTINAL POLYPEPTIDE-IMMUNOREACTIVE INNERVATION AND MAST-CELLS, Digestive diseases and sciences, 41(8), 1996, pp. 1665-1671
Recent studies suggest that substance P (SP), vasoactive intestinal po
lypeptide (VIP), and mast cells play a role in inflammatory processes
of the bowel. The aim of this study was to evaluate the distribution o
f SP and VIP immunoreactivities and to count mast cells in the ileal p
ouch of patients, who had pouchitis after restorative proctocolectomy
performed for treatment of ulcerative colitis (UC), and to compare the
findings in the same patients after a follow-up period, Nine patients
with pouchitis underwent clinical evaluation, endoscopy of the pouch,
and histological examination, which were repeated after the follow-up
period of 14 months on average, The number and intensity of SP- and V
IP-immunoreactive nerve fibers were visualized by immunofluorescence m
icroscopy and subjected to quantitative scoring, and the number of mas
t cells per unit area was counted. The results were compared to the hi
stological findings and the clinical status. Lamina propria contained
fibers showing bright immunofluorescence for SP and VIP, The mean fluo
rescence intensity score of SP-immunoreactive nerve fibers in the lami
na propria remained similar after the follow-up period (2.99 +/- 0.79
and 2.06 +/- 0.82, NS). SP-immunoreactive innervation correlated with
the grade of acute (R(2) = 0.5396, P = 0.0242) and chronic inflammatio
n (R(2) = 0.4561, P = 0.0459), while SP and VIP immunoreactivity, mast
cell count, and histological changes did not correlate with the clini
cal status. The present study demonstrates an increase in the density
of SP-immunoreactive nerve fibers in inflamed ileal pouch mucosa of cl
inically asymptomatic pouchitis patients, These results raise the poss
ibility of therapeutic interference of SP-related processes in treatme
nt of pouchitis.