Increased transmucosal permeation of bacterias in chronic inflammatory bowel diseases

Background: Bacterias play a possible role in the pathogenesis of chronic i nflammatory bowel disease. The aim of this study was to examine the importa nce of transmucosal permeation in (IBD). Methods: Patients: Ulcerative colitis (UC): 13 pat. (f:m=8:5, age 36 (23-71 )), specimen were taken from the terminal ileum and colon during proctocole ctomy. 12 (4-34) Truelove; Crohn's disease (CD):15 patients (f:m=9:6; Age 3 4 (23-59) Jahre; Specimen from bowel-resections for C.D.; CDAI 250 (130-400 ). The specimen were mounted into the ussing-chamber. After a stabilisation a defined amount of E. coli was added to the mucosal side of the epitheliu m. Over 4 hours hourly probes were taken from the mucosal and serosal side of the epithelium. After an incubation time of 24 h the colony forming unit s were counted. A count more than 1 unit was defined as significant for per meation. Results: In the ileum of controls was no permeation of E. Coli through the intact mucosa. In contrastM. Crohn und Colitis ulcerosa eine deutliche Perm eation in 40% (Ileum Colitis ulcerosa) und 50% (Ileum M. Crohn) auf Im Colo n von Kontrolle fand sich in einem Fall eine eindeutige Permeation. M. Croh n und Colitis ulcerosa fanden hier jedoch noch deutlich hohere Werte mit 14 % versus 44%. Conclusions: 1. IBD show an increased permeation of transmucosal E. Coli pe rmeation. 2. This could explain toxic courses in IBD. 3. Our results give a reasonable hint for an important role of bacteria in IBD pathogenesis.