JEJUNAL RELEASE OF PROSTAGLANDIN-E(2) IN CROHNS-DISEASE - RELATION TODISEASE-ACTIVITY AND FIRST-DEGREE RELATIVES

Patients with Crohn's disease of the distal ileum show increased perme ability to hyaluronan and increased release of histamine and complemen t components in uninvolved parts of the proximal jejunum. These abnorm alities are related to disease activity, and are not found in first-de gree relatives. Increased synthesis of prostaglandins has been observe d in inflamed areas of the intestine in active Crohn's disease. Our pu rpose was to measure luminal prostaglandin release in patients with ac tive and inactive Crohn's disease and their first-degree relatives. Tw enty-four patients with Crohn's disease of the distal ileum (10 in rem ission and 12 with inflammatory activity) and 17 of their first-degree relatives were included and compared with healthy control subjects (n = 39). Ten centimetres of the proximal jejunum was isolated between b alloons as described previously and perfused with a balanced electroly te glucose-containing solution. Luminal concentrations of PGE(2) and a lbumin were measured and their luminal release was calculated. Luminal release of PGE(2) was significantly higher in patients with Crohn's d isease than in control subjects [69.7+/-11.5 and 34.0+/-4.7 pg/cm per h (3.7+/-0.6 and 1.8+/-0.3 ng/L), respectively, P < 0.01]. The PGE(2) levels, however, were not positively correlated to disease activity. F urthermore, there was a modest, but significant increase in luminal PG E(2) in first-degree relatives [53.6+/-7.0 pg/cm per h (2.9+/-0.4 ng/L ), P < 0.05]. These changes were not accompanied by significant change s in luminal permeation of albumin. The stimulated jejunal synthesis o f prostaglandins observed in patients with Crohn's disease and to some extent in their relatives may constitute a response to altered geneti c mucosal characteristics.