Ornithine decarboxylase in colonic mucosa from patients with moderate or severe Crohn's disease and ulcerative colitis

Polyamines, as well as ornithine decarboxylase (ODC), the enzyme involved i n their synthesis, were reported to be closely related to cell proliferatio n. In Crohn's disease and ulcerative colitis, cell destruction and prolifer ation increase in the active stage. The aim of the present study was to det ermine the ODC in both involved and uninvolved areas of the colonic mucosa of active Crohn's disease and ulcerative colitis patients. The patients wer e divided in two groups, owing to the different level of activity (severe o r moderate), by means of clinical endoscopy, laboratory, and histology eval uations. Subjects with suspected disease, but endoscopically unconfirmed, w ere used as controls. In all ulcerative colitis and Crohn's disease patient s the ODC values both in involved and uninvolved mucosa were significantly lower than in controls. In severe Crohn's disease ODC was significantly red uced versus moderate Crohn's disease only in affected tissues. In all ulcer ative colitis patients (moderate or severe) the ODC was significantly decre ased in involved mucosa compared with uninvolved mucosa, Severe ulcerative colitis showed the significantly lowest ODC, We suggest that the significan t decrease of ODC in the bowel mucosa is closely related to the severity of the disease, The highest decrease of ODC in ulcerative colitis patients wo uld be due both to the enhanced cell destruction, and to the feed-back from exogenous increased polyamine production (bowel bacteria, cell desquamatio n). Therefore ODC would be considered a sensitive index of the inflammatory derangement of the mucosa, especially in acute ulcerative colitis. We conc lude that this behaviour may result in an enhanced risk of neoplasia, fur J Gastroenterol Hepatol 11:903-904 (C) 1999 Lippincott Williams & Wilkins.