Inflammatory bowel disease

Nicotine and serotonin in immune regulation and inflammatory processes: a perspective

Nicotine and serotonin modulate the innate and adaptive immune responses and the inflammatory states. Several nicotinic cholinergic and serotonergic receptor subtypes have been characterized in B and T lymphocytes, monocytes, macrophages, and dendritic cells. The use of knockout mice has allowed a better characterization of nicotinic receptors and their role in anti-inflammatory processes in these cells. Cytokines play a crucial role in controlling inflammatory reactions. Nicotine and serotonin have been reported to regulate cytokine release. Cholinergic mechanisms also play an important role in inflammation through endogenous acetylcholine. Nicotine mimics this effect by activating the cholinergic anti-inflammatory pathways. New concepts of reciprocal interactions between nicotine and serotonin are emerging. The role of nicotine as an anti-inflammatory agent has been established, whereas that of serotonin remains more controversial.

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Expression of Th1/Th2 cytokines in intestinal mucosa of ulcerative colitis

AIM

To investigate the effects of the expression of Th1/Th2 cytokines in intestinal mucosa with ulcerative colitis.

METHODS

Thirty patients (24 males, 6 females, age 18-79 years) with severe ulcerative colitis (UC) were examined by colonoscope, the diagnosis was confirmed by histological method. Bacterial infection was excluded through consecutive stool cultures twice. And ameba, schistosomiasis, gastroen-terological cancer and endocrine diseases were also excluded. Ulcerative colitis was found in omni-colon (n = 15) , sigmoid (n = 9), rectum (n = 6), respectively. Its clinical categories included relapse (n = 20), persistent (n = 7) and initial (n = 3).They were treated by Sulphasalazine (SASP) and glucocorticoid after histological diagnosis. Eight weeks later, they were re-examined by colonoscope. The expression of cytokines in the intestinal mucosa of UC patients were detected by a semi-quantitative assay, reverse transcription-polymerase chain reaction(RT-PCR) before and after treatment respectively.

RESULTS

Comparison with control groups, the expression of TNF-α, IL-2 was increased but IL-4 was decreased in the intestinal mucosa in acute stage. Sulphasalazine (SASP) and glucocorticoid inhibited inflammation by reducing the expression of TNF-α from 1.22±0.02 to 0.78±0.08 (P<0.01) and of IL-2 from 0.82±0.06 to 0.47±0.04 (P<0.01), and elevate the expression of IL-10 from 0.68±0.03 to 0.91±0.02(P<0.01).

CONCLUSION

There is an imbalance of Th1 and Th2 phenotype cytokine in patients with ulcerative colitis.

Crohn's disease: disastrous consequences of late diagnosis

Chronic and recurrent perianal abscess is an uncommon condition in children. Tuberculosis is thought to be the common etiology for such a presentation in India. We report a case of a child with colonic and perianal disease due to Crohn's disease and emphasize the disastrous complication due to delayed diagnosis.