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Development of pouchitis following ileal pouch-anal anastomosis (IPAA) for ulcerative colitis: A role for serological markers and microbial pattern recognition receptor genes.
MedLine Citation:
PMID:  21172204     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 role 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 S87I [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 pathophysiological role of the faecal flora in the development of pouchitis.
Authors:
Marc Ferrante; Sarah Declerck; Tamara Coopmans; Gert De Hertogh; Gert Van Assche; Freddy Penninckx; Paul Rutgeerts; Karel Geboes; Andre D'Hoore; Séverine Vermeire
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Publication Detail:
Type:  Journal Article     Date:  2007-11-26
Journal Detail:
Title:  Journal of Crohn's & colitis     Volume:  2     ISSN:  1873-9946     ISO Abbreviation:  J Crohns Colitis     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101318676     Medline TA:  J Crohns Colitis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  142-51     Citation Subset:  -    
Affiliation:
Department of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B3000 Leuven, Belgium.
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