Low trypsinogen-1 expression in pediatric ulcerative colitis patients who undergo surgery

Table 1 Clinical data of the pediatric study groups at the time of diagnostic endoscopy

Patient groups	Surgery	Disease	Non-IBD
		controls	controls
No. of patients (male)	24 (11)	27 (15)	20 (10)
Age at diagnosis (yr), median (range)	13.1 (3.1-16.0)	12.1 (2.8-16.6)	13.5 (2.7-16.8)
Time from diagnosis to surgery (yr), median (range)	2.1 (0.1-7.4)	-	-
Follow-up (yr), median (range)	-	6.3 (2.8-10.7)	1.0 (0.0-4.0)
Endoscopic disease extension
Proctitis	0	1	-
Left-sided colitis	9	6	-
Pancolitis	15	20	-
No inflammation	-	-	20
Histological inflammation1
No inflammation	-	-	18
Mild	6	10	1
Moderate to severe	18	17	-
Laboratory markers, median (range)
Hb (g/L)	112 (86-135)	116 (86-140)	131.0 (93-153)
ESR (mm/h)	25 (7-61)	22 (7-63)	8 (2-23)
CRP (mg/L)	20 (< 3-92)	9 (< 5-36)	< 3 (< 3-< 5)
WBC (E9/L)	9.6 (6.7-26.3)	7.5 (4.1-15.9)	5.1 (3.0-16.3)
Alb (g/L)	34.6 (28.0-40.0)	36.2 (23.6-42.6)	42.3 (39.8-47.2)

¹For the non-inflammatory bowel disease (IBD) controls, data were missing in one case. Alb: Albumin; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; Hb: Haemoglobin; WBC: White blood cell count.

Table 2 Surgical data for 24 pediatric patients with ulcerative colitis

Age at first surgery (yr), median (range)	15.3 (5.5-19.8)
Time from diagnosis to surgery (yr), median (range)	2.1 (0.1-6.6)
Indication for primary operation
Stricture	1 (perianal)
Refractory disease to medication	20
Steroid-dependency	18
No response to TNF-alpha antagonist	2
Fulminant colitis	3
Primary operation
Colectomy (IRA)	1
Proctocolectomy (IPAA)	23

IPAA: Ileal pouch anal anastomosis; IRA: Ileorectal anastomosis; TNF: Tumor necrosis factor.

Table 3 Semi-quantitative immunopositivity (score 0 to 3) and number of positive samples in the diagnostic colonic tissue samples of pediatric ulcerative colitis patients and non inflammatory bowel disease patients

	Surgery (n = 24)	Conservative treatment controls (n = 27)	Non-IBD controls (n = 20)	P valueSurgery vs conservative treatment controls	P valueSurgery vs non-IBD controls
Number of positive samples n (%)
Tryp-1
Epithelium	13 (57)	19 (76)	15 (79)	0.22	0.19
Stroma; inflammatory cells	11 (48)	8 (32)	5 (26)	0.38	0.21
Tryp-2
Epithelium	21 (95)	21 (81)	18 (95)	0.20	0.22
TATI
Epithelium	18 (78)	24 (92)	15 (75)	0.23	1.00
MMP-9
Epithelium	4 (18)	2 (8)	0 (0)	0.40	0.17
Stroma; inflammatory cells	11 (50)	12 (48)	1 (5)	1.00	0.0061
Median immunopositivity
Tryp-1
Epithelium	1.0	2.0	2.0	0.032	0.042
Stroma; inflammatory cells	0.0	0.0	0.0	0.16	0.10
Tryp-2
Epithelium	1.0	1.0	1.0	0.56	0.38
TATI
Epithelium	1.0	1.0	1.0	0.81	0.97
MMP-9
Epithelium	0.0	0.0	0.0	0.33	0.17
Stroma; inflammatory cells	0.5	0.0	0.0	0.89	0.0033

¹Both UC patient groups had significantly more positively stained inflammatory cells in their colonic epithelium when compared to the non-IBD controls;

²The patients who had undergone surgery had significantly lower immunopositivity when compared to the conservatively treated and non-IBD controls;

³Both UC patient groups had significantly higher immunopositivity when compared to the non-IBD controls. IBD: Inflammatory bowel disease; UC: Ulcerative colitis; TATI: Trypsin inhibitor; Tryp-2: Trypsinogen-2; MMP-9: Matrix metalloproteinase-9.