Increased Colonic Epithelial Permeability and Mucosal Eosinophilia in Ulcerative Colitis in Remission Compared With Irritable Bowel Syndrome and Health

• Published in: Inflammatory bowel diseases Vol. 26; no. 7; pp. 974 - 984
• Main Authors: Katinios, Georgios, Casado-Bedmar, Maite, Walter, Susanna A, Vicario, Maria, González-Castro, Ana M, Bednarska, Olga, Söderholm, Johan D, Hjortswang, Henrik, Keita, Åsa V
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 18-06-2020
• Subjects: Adult; Analysis; Biopsy; Care and treatment; Case-Control Studies; Colitis, Ulcerative - complications; Colitis, Ulcerative - metabolism; Colitis, Ulcerative - pathology; Colon - metabolism; Colon - pathology; Editor's Choice; Eosinophilia - etiology; Eosinophilia - metabolism; Eosinophilia - pathology; Ethylenediaminetetraacetic acid; Female; Humans; Intestinal Mucosa - metabolism; Intestinal Mucosa - pathology; Irritable bowel syndrome; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - metabolism; Irritable Bowel Syndrome - pathology; Leading Off; Male; Middle Aged; Permeability; Remission Induction; Somatotropin; Ulcerative colitis; Young Adult; Sweden; Spain; eosinophils; intestinal permeability; ulcerative colitis; mast cells; irritable bowel syndrome
• ISSN: 1078-0998; 1536-4844; 1536-4844
• DOI: 10.1093/ibd/izz328

Abstract
Background
Barrier dysfunction is recognized as a pathogenic factor in ulcerative colitis (UC) and irritable bowel syndrome (IBS), but it is unclear to what extent the factors related to barrier dysfunction are disease-specific. The aim of this study was to compare these aspects in UC patients in remission, IBS patients, and healthy controls (HCs).
Methods
Colonic biopsies were collected from 13 patients with UC in remission, 15 patients with IBS-mixed, and 15 HCs. Ulcerative colitis patients had recently been treated for relapse, and biopsies were taken from earlier inflamed areas. Biopsies were mounted in Ussing chambers for measurements of intestinal paracellular permeability to 51chromium (Cr)-ethylenediaminetetraacetic acid (EDTA). In addition, biopsies were analyzed for mast cells and eosinophils by histological procedures, and plasma tumor necrosis factor (TNF)-α was assessed by ELISA.
Results
Ussing chamber experiments revealed an increased 51Cr-EDTA permeability in UC and IBS (P < 0.05). The 51Cr-EDTA permeability was higher in UC compared with IBS (P < 0.005). There were increased numbers of mucosal mast cells and eosinophils in UC and IBS and more eosinophils in UC compared with IBS (P < 0.05). Also, increased extracellular granule content was found in UC compared with HCs (P < 0.05). The 51Cr-EDTA permeability correlated significantly with eosinophils in all groups. Plasma TNF-α concentration was higher in UC compared with IBS and HCs (P < 0.0005).
Conclusions
Results indicate a more permeable intestinal epithelium in inactive UC and IBS compared with HCs. Ulcerative colitis patients, even during remission, demonstrate a leakier barrier compared with IBS. Both eosinophil numbers and activation state might be involved in the increased barrier function seen in UC patients in remission.
Main results from this study indicate a more permeable intestinal epithelium in inactive UC and IBS compared with HCs. Moreover, UC patients, even during remission, demonstrate a leakier barrier compared with IBS, which seems to be associated with eosinophils.