Public release date: 10-Oct-2013 [ | E-mail | Share ]

Contact: Connie Hughes connie.hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health

Philadelphia, Pa. (October 10, 2013) "Pouchitis" developing after surgery for ulcerative colitis (UC) is associated with changes in gene expression, which increase along with disease severity, reports a study in Inflammatory Bowel Diseases, official journal of the Crohn's & Colitis Foundation of America (CCFA). The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Gene alterations in pouch inflammation and Crohn's disease overlap, suggesting that inflammatory bowel disease is a spectrum, rather than distinct diseases," according to the new research by Dr S. Ben Shachar and colleagues of Tel Aviv University, Israel. They believe the occurrence and progression of gene changes in previously normal intestine after UC surgery provides a useful model for studying the development of inflammatory bowel disease (IBD).

After UC Surgery, Gene Expression Changes in Patients with "Pouchitis"

The researchers analyzed gene expression changes in different groups of patients who had undergone "pouch" surgery for UC. In this procedure (restorative proctocolectomy), the entire large intestine is removed and a portion of small intestine (the ileum) is used to create a reservoir, or pouch, to restore bowel function.

Up to one-fourth of patients with UC need surgery because of unmanageable disease or complications. Surgery is effective, but has a substantial rate of complicationsespecially the development of inflammation in the newly created pouch, called pouchitis.

By definition, the small intestine is normal in UCin contrast to Crohn's disease (CD), which can affect any part of the gastrointestinal tract. The development of pouchitis after UC surgery thus provides an opportunity to study the "molecular events" associated with the development of IBD in previously normal tissue.

The researchers found no significant changes in gene expression in normal samples of ileum from patients with UC. In contrast, in patients who had undergone UC surgery, nearly 170 significant changes in gene expression were found in samples of tissue from the surgically created poucheven though the tissue still appeared normal.

In patients who had developed inflammation and other signs of pouchitis, the number of gene abnormalities increased to nearly 500. For those who progressed to develop "Crohn's-like" changes of the pouch tissue, the number of gene abnormalities increased to well over 1,000. Thus as the severity of pouch disease increased, so did the number of gene expression changes.

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'Pouchitis' after ulcerative colitis surgery linked to changes in gene expression

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