| Ulcerative colitis (UC) is a non-specific chronic inflammation involvingmucosa and submucosal of rectum and colon. The major clinicalmanifestations are abdominal pain, diarrhea, mucus blood and pus, tenesmus.Illness state delayed healing, active and remission period alternately appear,and it may be cancerous. In recent years, the incidence is rising, its etiologyand pathogenesis have not been fully elucidated. Currently we consider thatdue to the combined effect of environmental factors, genetic susceptibility,intestinal flora imbalance, immune dysfunction, oxygen free radicals injuryand psychological factors. A growing number of scholars believe that UC is anautoimmune disease. Immune hyperthyroidism, Immune dysregulation andthe onset of UC are closely related. Immune regulation is the most active areasof the UC study. T cell subsets function disorders and the imbalance betweenpro-inflammatory cytokines and anti-inflammatory cytokines play importantroles in immune regulation and are closely related to its activities.β-endorphin (β-EP) is one of the endogenous opioid peptides that isproduced by the body. It is synthesised and secreted by the pituitary andperipheral immune cells. And it exists in the pituitary, hypothalamus,gastrointestinal tract and plasma. β-EP 's synthesis and release are regulatedby the hypothalamus-pituitary-adrenal axis regulation. Through μ, κ, δ as themain body of the central and peripheral opioid receptors, β-EP plays a widerange of physiological effects. Through combination with opioid receptors andnon-opioid receptors that on the surface of immune cells, β-EP regulate theimmune regulation that immune cells and cytokines mediated. β-EP plays animportant role in immune regulation and is an important factor to maintainbody immune balance. The research on the role of β-EP in the UCimmunomodulatory is rarely reported at home and abroad. Objective: To observe the β-EP in plasma, T cell subsets and IL-1βchanges in the active phase and the remission phase, and their correlation inpatients with UC. To observe the colon histopathology changes and tomeasure β-EP and IL-1β levels in colon. To explore the regulatory role and itsimmune mechanisms of β-EP. So to provide a new target and direction forclinical treatment of UC.Methods: We took blood samples and colonic mucosa from30patientswhose UC was in active, and15colorectal polyps patients. Patients werediagnosed as UC by clinical manifestations, colonoscopy and mucosalhistological examination. In addition, we took blood samples from the30patients when their UC was in remission (UCr). According to SoutherlandDAI score, UC patients were divided into three groups, the mild activity group,the moderate activity group and the severe activity group. All groups had nodifference in age and gender (P>0.05). In this study, the blood content of β-EPand IL-1β was measured by radioimmunoassay in30patients with UC and15controls; the blood content of T-cell subsets (CD3~+, CD4~+, CD4~+/CD8~+) wasmeasured by flow cytometer in30patients with UC and15controls; thecolonic mucosal content of β-EP and IL-1β was measured byimmunohistochemistry in30patients with UC and15controls. According tothe detection result, to understand each blood indicator of whether there wassignificant differences between the UC group and control group. Among them,the UC group included active and remission phases；to evaluate whether thelevels of all parameters in tissue of UC patients in the active phase weresignificantly different from those in the the control group; statistics of UCpatients in active stage and in remission phase plasma beta-EP withCD3~+,CD4~+and CD4~+/CD8~+, IL-1β in changes analysis, to understandwhether there was a correlation between their changes.Results:1Serological test1.1Plasma expression of β-EP in the case group was significantly higher thanthat of control group (P <0.05). The expression level of β-EP in each group as follows: normal group <mild activity group <moderate activity group <severe activity group, and differences between groups was statisticallysignificant (P<0.05).1.2Serum expression of IL-1β in the case group was significantly higher thanthat of control group (P <0.05). The expression level of IL-1β in each groupas follows: normal control group <mild activity group <moderate activitygroup<severe activity group, and differences between groups was statisticallysignificant (P<0.05).1.3Plasma expression of CD3~+,CD4~+and CD4~+/CD8~+in the case group weresignificantly higher than that of control group (P <0.05). The expression levelsof CD4~+and CD4~+/CD8~+in each group as follows: normal control group <mild activity group <moderate activity group <severe activity group, anddifference between groups was statistically significant (P<0.05).2Colon tissue test2.1Colonic expression of β-EP in the case group was significantly higher thanthat in the control group (P<0.05). β-EP expression levels in each group asfollows: normal control group <mild activity group <moderate activitygroup <severe activity group, and difference between groups was statisticallysignificant (P<0.05).2.2Colonic expression of IL-1β in the case group was significantly higherthan that in the control group (P<0.05). IL-1β expression levels in each groupas follows: normal control group <mild activity group <moderate activitygroup <severe activity group, and difference between groups was statisticallysignificant (P<0.05).3Correlation analysis3.1The change of plasma β-EP between the active phase and the remissionphase was positively correlated with the change of CD4~+(r=0.532, P <0.05).3.2The change of plasma β-EP between the active phase and the remissionphase was positively correlated with the change of CD4~+/CD8~+(r=0.964, P<0.05).3.3The change of plasma β-EP between the active phase and the remission phase was positively correlated with the change of IL-1β (r=0.522, P <0.05).Conclusions:1Expression of β-EP in plasma and colon tissue in active UC patients aremarkedly increased compared with those in control group, and its expressionincreased as the disease worsens, to some extent, it can reflect the severity ofthe disease.2IL-1β, CD3~+, CD4~+and CD4~+/CD8~+expression in the case group aresignificantly higher than those in control group, which verify the UC patientswith immune adjustment disorders and immune hyperactivity.3The change of plasma β-EP of UC patients between the active phase and theremission phase is positively correlated with the change of CD4~+,CD4~+/CD8~+,IL-1β, indicating β-EP may play a role in the immunologicalmechanism of UC by regulating the leukomonocyte subgroup and thesecretion of IL-1β.4Monitoring the expression level of β-EP has an important significance to theassessment of disease severity in patients with UC. β-EP is involved in theregulation of immune mechanisms of patients with UC, through itsmechanism of action of β-EP treatment in patients with UC provides atheoretical basis, a new opportunity for the clinical treatment of UC. |
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