Wmc. Rosenberg et al., INCREASED EXPRESSION OF CD44V6 AND CD44V3 IN ULCERATIVE-COLITIS BUT NOT COLONIC CROHNS-DISEASE, Lancet, 345(8959), 1995, pp. 1205-1209
Immune mechanisms, possibly involving cell-surface molecules such as C
D44, have been invoked to explain the pathogenesis of inflammatory bow
el disease. We used monoclonal antibodies against epitopes encoded wit
hin the variable region of CD44 to investigate CD44 isoform expression
in colon, small intestine, and liver in patients with various intesti
nal disorders and in controls. Biopsy samples from patients with ulcer
ative colitis showed significantly increased epithelial expression of
CD44 isoforms containing the v6 and v3 epitopes, detected with antibod
ies 2F10 and 3G5, respectively. CD44v6 was detected on colonic crypt e
pithelial cells in 23 of 25 ulcerative colitis samples compared with 3
of 18 colonic Crohn's disease samples (p=3.0x10(-6); odds ratio 57.5
[95% CI 6.83-702]) and 3 of 52 controls (22 normal colon, 10 infective
colitis, 2 radiation colitis, and 18 colonic Crohn's disease; p<1x10(
-8); odds ratio 199 [25.5-2294]). No significant expression of CD44v6,
CD44v3, or CD44v8/9 was found in samples of normal proximal colon fro
m 4 patients with distal ulcerative colitis, whereas samples from the
affected area showed staining for CD44v6 and CD44v3. No expression of
CD44 variants was found in 15 samples of normal small intestine, 11 sm
all-bowel pouchitis, 8 coeliac disease, 3 small-bowel Crohn's disease,
6 normal liver, 6 primary biliary cirrhosis, or 9 primary sclerosing
cholangitis. The high intensity of CD44v6 and v3 epitope expression on
crypt epithelial cells in ulcerative colitis suggests that CD44 isofo
rms may have an important role in ulcerative colitis. Their detection
could have diagnostic potential in differentiating ulcerative colitis
from other forms of colonic inflammation including Crohn's disease.