期刊
JOURNAL OF CROHNS & COLITIS
卷 2, 期 2, 页码 142-151出版社
OXFORD UNIV PRESS
DOI: 10.1016/j.crohns.2007.10.003
关键词
Ulcerative colitis; Pouch; Pouchitis; Predictor; Genetics; Serology
Background and Aims: Pouchitis, the most common complication after proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis, has been attributed to altered composition of faecal flora. We investigated the rote of antimicrobial and antiglycan antibodies and polymorphisms in microbial pattern recognition receptor genes. Methods: Clinical charts of all 184 patients with ulcerative colitis who underwent IPAA between 1990-2004 were reviewed for pre- and post-operative disease course. Results: Follow-up data were available in 172 patients [67 female, median age at proctocolectomy 39.1 years]. During a median follow-up of 6.7 (interquartile range 3.7-10.5) years, 80 patients (47%) developed at least one episode of pouchitis. Cox proportional-hazard regression identified extra-intestinal, manifestations [HR 1.78 (95%CI 1.10-2.88), p = 0.020], a GT/TT genotype at Toll-like-receptor-1 S871 [HR 1.64 (1.01-2.66), p = 0.047], anti-chitobioside carbohydrate antibodies [HR 2.03 (1.11-3.70), p = 0.021] and young age at diagnosis [p = 0.003] to be independently associated with pouchitis. Factors associated with chronic pouchitis, diagnosed in 33 patients (19%), were extra-intestinal manifestations [HR 2.45 (1.07-5.62), p = 0.034], backwash ileitis [HR 3.15 (1.10-9.00), p = 0.032], outer-membrane porin antibodies [HR 2.67 (1.20-5.94), p = 0.016] and young age at proctocolectomy [p = 0.008]. Conclusions: The reported association with antibodies and Toll-like-receptor-1 supports the pathophysiotogical rote of the faecal flora in the development of pouchitis. (c) 2007 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
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