RESUMEN
The objective of this study was to investigate how the development of sarcoidosis influences the disease course of mixed connective tissue disease (MCTD). The cellular composition of MCTD-associated sarcoidosis granulomas was evaluated and also the disease-accompanying T-cell activation and alterations of the serum cytokine levels were measured before and after the therapy. The HLA-DR specific alleles were also assessed. We present two cases with MCTD coexisting sarcoidosis. Serum concentrations of Th1 and Th2 cytokines were assessed by ELISA. Peripheral blood CD3+ total T-cell numbers, CD4+ and CD8+ T-cell subset were determined by flow cytometry. Furthermore, hematoxylin-eosin staining and immunhistochemistry were performed for histological assessment. HLA-DR specific alleles were determined by using PCR-SSP. Elevated number of activated T-cells and high Th1 cytokine levels were detected, mainly IFN-gamma and TNF-alpha. Histologically, CD4+ and CD8+ T-cells were present in the sarcoidosis infiltrations. The haplotypes were to some extent dissimilar from the HLA-DR genotype from patients with MCTD, or sarcoidosis alone. Sarcoidosis enhances the activation of MCTD, based on the laboratory and clinical findings. Our results show that the inflammation is mainly in the effector phase, while granuloma formation is characteristic of the resolution phase of the disease. The assessment of the cytokine network in sarcoidosis-associated MCTD enables us to select the most effective, individualized therapy protocol for these patients.
Asunto(s)
Enfermedad Mixta del Tejido Conjuntivo/sangre , Enfermedad Mixta del Tejido Conjuntivo/complicaciones , Sarcoidosis/sangre , Sarcoidosis/complicaciones , Femenino , Granuloma/patología , Humanos , Persona de Mediana Edad , Enfermedad Mixta del Tejido Conjuntivo/genética , Enfermedad Mixta del Tejido Conjuntivo/patología , Radiografía Torácica , Sarcoidosis/genética , Sarcoidosis/patologíaRESUMEN
AIM: To evaluate the relationship between symptoms and microscopic colitis (MC) subtypes: to test whether collagenous colitis (CC) and/or lymphocytic colitis (LC) might be related to both constipation and diarrhea. METHODS: A cohort of patients with independently confirmed typical histopathological changes was investigated. Fifty-three patients with histologically proved MC (46 with CC, 7 with LC) were included. The existence of diarrhea or constipation and the co-existence of autoimmune diseases were also investigated and all data were retrospectively analyzed. RESULTS: Twenty-three (43.39%) of MC patients had chronic constipation (20 in CC, 3 in LC patients). Twenty-four (45.28%) of MC patients had autoimmune disease and the diagnosis of autoimmune disease was always prior to MC. Sjögren's syndrome was associated only with the constipation subgroup. CONCLUSION: The Janus face of MC resembles the subgroups of irritable bowel syndrome. The co-existence of autoimmune diseases and MC is confirmed in both the constipation and diarrhea subgroups.
Asunto(s)
Colitis/clasificación , Colitis/patología , Colon/patología , Mucosa Intestinal/patología , Adulto , Enfermedades Autoinmunes/patología , Estudios de Cohortes , Estreñimiento/patología , Diarrea/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: The irritable bowel syndrome (IBS) is a functional bowel disorder characterized by symptoms of abdominal pain that is associated with disturbed defecation. Crohn's disease (CD) and Ulcerative colitis (UC) are collectively referred to as inflammatory bowel diseases (IBD). IBD appears to result from dysregulated immune response with contributions from genetic predisposition and environmental factors. Among environmental factors the enteric microflora and the components of food (eg. antigens) may play important role in the pathogenesis of IBD. The aim of the authors' study was to detect IgE type antibodies against the most frequent food allergens in patients with IBD and IBS. METHODS: Antibodies against food allergens (IgE type) with ELISA method in patients with CD, UC and IBS were quantitatively measured. The figures were compared to the result of a healthy control group contains the same number of participants, and the frequency of food allergy in these patient groups were determined. RESULTS: On the basis of the study the presence of increased IgE type immune response against any food allergens was 34.5% (p = 0.01) in the group of IBS. In patients with CD or UC the immune response against food allergens was also more frequent than in the control group. The order of frequency of food allergens in IBS was the following: milk protein, soybean, tomato, peanut, egg white. CONCLUSION: As the occurrence of food allergens was significantly higher in IBS group than in the control group, the role of food allergy in the symptoms of IBS can be come up. The frequency of food allergy in patients with diagnosis of IBS, and the similarity of symptoms of this two diseases give an obvious opportunity for the patients with IBS to use a diet avoiding the most frequent food allergens, or take e.g. Na-cromoglycate which is useful therapy in food allergy.