The Expression Of TNF-α, ICAM-1 And CD44s In Colonic Mucosa Of Ulcerative Colitis Patients

Background and aims: Ulcerative colitis(UC) is a chronic disease. Although the true pathogenesis of it is still unknown, there are evidences that many ingredients including environment, inheritance, infection, allergy, psychological factors, and some immunological factors may be involved in its development. It is widely believed that immunological mechanisms play important roles in the process. Cytokines and adhesion molecules have been studied to elucidate their roles in the development of these long-standing intestinal inflammations recently. We aimed to investigate the expression of tumor necrosis factor-α (TNF-α),intercellular adhesion molecule-1 (ICAM-1) and CD44s in colonic mucosa in UC and study the relationship between the three parameters and disease activity.Methods: Thirty patients with clinically and endoscopically determined UC were studied. Twenty-five patients had active UC, which was divided into mild group(10 cases) and moderate or severe group(15 cases together),and five had inactive UC. The expression and localization of TNF-α,ICAM-1 and CD44s were examined in colonic biopsy specimens by immunohistochemistry. Chose ten colonic mucosa 10cm parted from single colon polypus as normal controls. All groups had no differences at age and sex. Positive cells of the sections were counted by Image Analysis System. Five visual fields(10×40) were selected at random. Average numbers per millimeter square were used as actual figures. Differences among groups were compared by SPSS11.5 statistics software using ANOVA and LSD test. P<0.05 was selected as significant standard.Results: Positive position of TNF-α located on cell membrane or plasm with brown in macrophages. Positive cells in moderate or severe UC (215.7±24.6) were more than that in mild UC(171.3±29.1)(P<0.01). The latter were more than that in remission group(89.2±22.1)(P<0.01). The least were in normal controls(51.2±19.6). The expression of ICAM-1 was consisted with TNF-α, but positive cells were lymphocytes, endothelium and gland epithelium. Positive cells in moderate or severe group(281.1±26.0)were more than that in mild UC(253.4±37.4)(P<0.05).That in mild UC were more than that in remission group(133.2±35.5)and in normal controls(57.5±20.9)(P<0.01). Positive position of CD44s located on cell membrane.Positive cells were lymphocytes,macrophages and fibroblasts et al.Positive cells in moderate or severe group were more than that in mild UC(292.3± 28.6vs 240.5±33.3, P<0.01). The latter were more than that in remission group(102.2±15.5)and normal controls(70.3±18.4)(P<0.01).Positive cells in remission group were more than in normal controls(P<0.05).Conclusions: The expression of TNF-α,ICAM-1 and CD44s in colonic mucosa was higher in active UC than that in inactive UC and in normal controls. It related to disease's severity. The three indexes might have very important roles in the disease's development and they could reflect the degree of inflammation in colonic mucosa indirectly, which helped to select therapy methods and hinted that antibodies aimed at cytokines and adhesion molecules might have some values in UC treatment.