Matsushita M, Takakuwa H, Matsubayashi Y, Nishio A, Ikehara S, Okazaki K. Appendix is a priming site in the development of ulcerative colitis. World J Gastroenterol 2005; 11(31): 4869-4874 [PMID: 16097061 DOI: 10.3748/wjg.v11.i31.4869]
Corresponding Author of This Article
Dr. Mitsunobu Matsushita, Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8506, Japan. matsumit@takii.kmu.ac.jp
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Brief Reports
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Mitsunobu Matsushita, Kazuichi Okazaki, Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan
Susumu Ikehara, First Department of Pathology, Kansai Medical University, Osaka, Japan
Hiroshi Takakuwa, Yuji Matsubayashi, Department of Gastroe-nterology, Tenri Hospital, Nara, Japan
Akiyoshi Nishio, Department of Gastroenterology and Endoscopic Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
Author contributions: All authors contributed equally to the work.
Supported by the Grant-in-Aid for Scientific Research (C) from the Ministry of Culture and Science of Japan No. 16560645; Grant-in-Aid for “Research for the Future” Program from The Japan Society for the Promotion of Science, No. JSPS-RFTF97I00201; Supporting in Research Funds from The Japanese Foundation for Research and Promotion of Endoscopy, No. JFE-1997; Shimidzu Immunology Foundation, 2000; Tenri Foundation for Medical Research, 1997-2000; Health and Labour Science Research Grants from the Japanese Ministry of Health, Labour and Welfare, and Research on Measures for Intractable Disease (Inflammatory Bowel Disease); a Grant from the “The 21st Century Center of Excellence (COE)” Program of the Ministry of Education, Culture, Sports, Science and Technology
Correspondence to: Dr. Mitsunobu Matsushita, Third Department of Internal Medicine, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi, Osaka 570-8506, Japan. matsumit@takii.kmu.ac.jp
Telephone: +81-6-6992-1001 Fax: +81-6-6996-4874
Received: December 13, 2004 Revised: January 1, 2005 Accepted: January 5, 2005 Published online: August 21, 2005
Abstract
AIM: The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis (UC). The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC.
METHODS: Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC: active pancolitis (A-Pan; n = 15), active left-sided colitis (A-Lt; n = 25), A-Lt with appendiceal involvement (A-Lt/Ap; n = 10), inactive pancolitis (I-Pan; n = 14), and inactive left-sided colitis (I-Lt; n = 22), and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4+ T cells were investigated, and compared with controls.
RESULTS: In the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. In the appendix, the proportion of CD4+CD69+ (early activation antigen) T cells significantly increased in all UC groups. In the rectum, the proportion of CD4+CD69+ T cells significantly increased only in A-Pan. The proportion of CD4+HLA-DR+ (mature activation antigen) T cells significantly increased only in the rectum of A-Pan, but not in the other areas of any groups.
CONCLUSION: The increased CD4/CD8 ratio and predominant infiltration of CD4+CD69+ T cells in the appendix suggest that the appendix is a priming site in the development of UC.
