☆ 4.4 Article

Similarity in the metabolic profile in macroscopically involved and un-involved colonic mucosa in patients with inflammatory bowel disease: an in vitro proton (1H) MR spectroscopy study

MAGNETIC RESONANCE IMAGING (2010)

Journal

MAGNETIC RESONANCE IMAGING

Volume 28, Issue 7, Pages 1022-1029

Publisher

ELSEVIER SCIENCE INC

DOI: 10.1016/j.mri.2010.03.039

Keywords

Inflammatory bowel disease; Ulcerative colitis; Crohn's disease; Involved and un-involved mucosa; In-vitro proton (H-1) magnetic resonance spectroscopy; Metabolite concentration

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Abstract

Background: The histological extent of inflammatory bowel disease (IBD) is greater than that evident by colonoscopic evaluation. We hypothesized that metabolic profile in macroscopically un-involved colonic mucosa in IBD is similar to that of controls with healthy colon. We thus assessed the differences in metabolic profile in macroscopically involved and un-involved colonic mucosa of IBD patients to further substantiate the extent of disease. Patients and Methods: Colonic mucosal biopsies were obtained and snap frozen from both the macroscopically un-involved and involved colonic mucosa of IBD patients and macroscopically normal colonic mucosa of controls and were subjected to in-vitro high-resolution proton (H-1) magnetic resonance (MR) spectroscopy and the concentrations of metabolites were determined. Results: Thirty-two metabolites were assigned in the proton MR spectrum of colonic mucosa of IBD patients. The concentrations of amino acids (isoleucine, leucine, valine, arginine, lysine, glutamine/glutamate, alanine), membrane metabolites (choline, glycerophosphorylcholine/phosphorylcholine), glycolytic product (lactate) and short chain fatty acid (formate) were significantly lower while significantly high level of glucose were observed in the macroscopically un-involved colonic mucosa of IBD patients compared to the macroscopically normal mucosa of controls. There was no significant difference in the concentrations of metabolites in macroscopically involved and un-involved colonic mucosa of IBD patients. Conclusions: The metabolic profile in macroscopically un-involved colonic mucosa of IBD patients is similar to that of macroscopically involved mucosa but different from colonic mucosa of controls. This suggests that even macroscopically un-involved colonic mucosa is metabolically abnormal and may explain the increase in extent of disease with time. (C) 2010 Elsevier Inc. All rights reserved.

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Impact of Anti-CD20 therapies on the immune homeostasis of gastrointestinal mucosa and their relationship with de novo intestinal bowel disease in multiple sclerosis: a review

A. Quesada-Simo, A. Garrido-Marin, P. Nos, S. Gil-Perotin

Summary: Multiple sclerosis (MS) and inflammatory bowel disease (IBD) are autoimmune disorders that cause inflammation in the brain and gastrointestinal (GI) tract, respectively. While they share common pathogenic mechanisms, their immune responses to treatment differ. Anti-CD20 therapies effectively control inflammation in MS but may cause bowel inflammation in susceptible individuals. This review explores the association between immunity in MS and IBD, the impact of anti-CD20 therapies on the gut microenvironment, and recommendations for early detection and management of GI toxicities in MS patients undergoing B-cell depletion.

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