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Are pANCA, ASCA, or Cytokine Gene Polymorphisms Associated with Pouchitis? Long-term Follow-up in 102 Ulcerative Colitis Patients

2004; Lippincott Williams & Wilkins; Volume: 99; Issue: 3 Linguagem: Inglês

10.1111/j.1572-0241.2004.04107.x

1572-0241

James Aisenberg, Peter Legnani, Naris Nilubol, Gena M. Cobrin, Sharif H. Ellozy, Refaat Hegazi, Jessica E. Yager, Carol Bodian, Stephen R. Gorfine, Joel J. Bauer, Scott E. Plevy, David B. Sachar,

Eosinophilic Esophagitis

OBJECTIVE Pouchitis is the most frequent complication after ileal pouch-anal anastomosis for ulcerative colitis. This study aims to analyze the frequency and characteristics of pouchitis in long-term follow-up in a large population, and to determine whether a significant association exists between five immunogenetic markers and pouchitis. METHODS From a population of over 500 ulcerative colitis patients who had undergone ileal pouch-anal anastamosis 5–12 yr earlier, 102 subjects participated in the study. Using clinical data obtained from interviews and chart reviews, patients were classified into three groups: no pouchitis; 1–2 episodes per year; and >2 episodes per year. Coded sera from the patients were analyzed for ulcerative colitis-associated perinuclear antineutrophil cytoplasmic antibodies and Crohn's disease-associated anti-saccharomyces cerevesiae antibodies. Interleukin-1 receptor antagonist, tumor necrosis factor (TNF), and lymphotoxin β (lymphotoxin) polymorphisms were also analyzed. RESULTS Pouchitis affected 49% of the study population. Antineutrophil cytoplasmic antibodies, anti-saccharomyces cerevesiae antibodies, and lymphotoxin-β polymorphisms were not associated with pouchitis. Carriage of interleukin-1 receptor antagonist allele 2 was significantly greater among those without pouchitis than those with pouchitis. Patients without pouchitis had a significantly greater carriage rate of TNF allele 2. CONCLUSIONS Perinuclear antineutrophil cytoplasmic antibodies and anti-saccharomyces cerevesiae antibodies are not correlated with pouchitis, but interleukin-1 receptor antagonist and TNF may play a role in its development. Further evaluation of these markers in pouchitis will require larger populations, long-term prospective observation, and studies that correlate polymorphisms with specific immunologic functions.