Pouchitis after total retocolectomy is one of the most common complication of patients with ulcerative colitis (UC), while its frequency is quite rare in familial adenomatous polyposis (FAP). PURPOSE: To evaluate the inflammatory activity in endoscopicaly normal mucosa of the ileal pouch, by determining the expression of TNF-alpha and IL-1beta, and the activation of NF-kappaB. METHODS AND PATIENTS: Twenty patients with "J" pouch after total retocolectomy were studied, being 10 patients with UC and 10 with FAP. The control group was constituted by biopsies from terminal ileum take during normal colonoscopy examination. Biopsies from mucosa of the pouch and from normal ileum were done, and they were snap-frozen in liquid nitrogen. The expression of TNF-alpha and IL-1beta were analyzed by total extract, and NF-kappaB was evaluated by immunoprecipitation and immunoblot. RESULTS: Expression of TNF-alpha and IL-1beta was increased in patients with UC, when it was compared with FAP (p<0.05). Conversely, the expression of NF-kappaB was increased in patients with UC, witch was not different from FAP. The control group had little expression of TNF-alpha (p<0.01). The activation of NF-kappaB (p>0.1) and the expression of IL-1beta (p>0.05) were similar, when comparing UC and FAP with control group. CONCLUSION: The patients with UC presented increased levels of the studied cytokines, even without clinic and endoscope evidence of pouchitis. These findings could be a suggestion of higher susceptibility to this complication among patients with UC.
ulcerative colitis; familial adenomatous polyposis; ileal pouch; pouchitis; cytokines
