GUT LAVAGE IGG AND INTERLEUKIN-1 RECEPTOR ANTAGONIST - INTERLEUKIN-1-BETA RATIO AS MARKERS OF INTESTINAL INFLAMMATION IN CHILDREN WITH INFLAMMATORY BOWEL-DISEASE

Background-Whole gut lavage is currently used as preparation before ra diological or endoscopic examination of the large bowel. Aim-To valida te the gut lavage technique for the assessment of mucosal inflammation , by measuring intestinal IgG and interleukin 1 beta (IL-1 beta) in th e fluid obtained. Patients-Sixteen children with Crohn's disease (CD), 14 with ulcerative colitis (UC), and 22 age matched controls. iMethod s-lsotonic, non-absorbable polyethylene glycol based lavage solution w as given orally or by nasogastric tube. Clear fluid was collected, fil tered, and treated with protease inhibitors. IgG, IL-1 beta and IL-1 r eceptor antagonist (IL-l-ra) were measured by sandwich enzyme linked i mmunosorbent assay (ELISA). Results-In patients with UC and CD, IgG an d IL-1 beta levels were significantly (p < 0.001) higher than in contr ols. A positive correlation (p < 0.05) was found with disease activity scores. IL-1-ra levels were not significantly different in UC and CD, when compared with controls, but the IL-1-ra:IL-1 beta ratio was sign ificantly (p < 0.01) lower in patients with UC and CD, and negatively (p < 0.001) correlated with IgG levels in lavage fluid. Conclusions-Gu t lavage fluid IgG and IL-1 beta levels and IL-1-ra:IL-1 beta ratio ma y provide objective discrimination between active and inactive disease in children with inflammatory bowel disease.