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ABSTRACT: Soluble angiogenic factors could be altered in patients with Crohns disease (CD), since inflammation and angiogenesis may play a critical pathogenic role.
Serum samples were collected from 30 patients with CD (50% female; median age 44 +/- 14 yrs) grouped according to their phenotypic behavior into equal subgroups: inflammatory, fibrostenotic and fistulizing; and 30 healthy controls (50% female; median age 43 +/- 14 yrs). Vascular endothelial growth factor (VEGF), placental growth factor (PlGF), angiopoietins (Ang) and receptors (VEGFR1, VEGFR2 and Tie2) in sera were assayed by ELISA.
Serum levels of VEGF (494 +/- 247 pg/ml), PlGF (36 +/- 11 pg/ml), VEGFR1 (1.9 +/- 0.3 ng/ml), Ang2 (6.0 +/- 2.3 ng/ml) and Tie2 (36 +/- 5 ng/ml) in CD patients were significantly higher than those found in healthy controls (335 +/- 118 pg/ml; 23 +/- 9 pg/ml; 1.0 +/- 0.3 ng/ml; 3.9 +/- 2.0 ng/ml; 22 +/- 7 ng/ml, respectively). Conversely, CD patients showed significantly lower serum levels of Ang1 than healthy controls (46 +/- 11 versus 67 +/- 23 pg/ml). In the case of VEGFR2 serum levels, no differences between groups were found. Finally, patients with fibrostenotic CD were characterized by elevated VEGF and Ang2 levels, while patients with an inflammatory phenotype by elevated Tie2 and PlGF levels.
An activated "pro-angiogenic" profile of angiogenesis soluble markers was observed in CD patients, in comparison with healthy controls. According to the phenotypic behavior, these patients showed differences in serum levels of angiogenic factors.
Gastroenterología y Hepatología 12/2007; 30(9):518-24. · 0.73 Impact Factor
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ABSTRACT: It has been suggested that appendicitis protects against ulcerative colitis. We hypothesize that early poor hygiene protects against ulcerative colitis (UC) and predisposes to appendicitis. Our aim was to elucidate the immunological characteristics of rectal mucosa in two populations protected against UC development: appendectomised subjects and inhabitants of developing countries.
this was an age-matched prospective case-control study. Each consecutive individual case appendectomised (group A) was compared to another control from a developing country (group B) and to a control from the general population (group C). Four biopsies from rectal mucosa were taken from all subjects, two for histological and two for histochemical study; specific antibodies were used for T lymphocytes CD3+, CD4+, CD8+ and B lymphocytes CD20+ populations.
Mucosa samples of 45 non-smoker healthy subjects were studied, of which 15 were from group A, 15 from group B and 15 from group C. In appendectomised subjects, the proportion of CD8+ cells was higher than in the control group (p<0.001), but similar to that in B group. The proportion of CD3+ and CD20+ cells was significatively lower than in Ecuadorians, but similar to the control group. In Ecuadorians, the proportion of CD3+ and CD8+ cells was significatively higher than in the control group (p<0.001), and were similar to that of CD20+. There were no significant differences in the proportion of CD4+.
Appendectomy and deficient environmental hygiene are associated with an increase of CD8+ T lymphocytes in the rectal mucosa. Moreover, deficient environmental hygiene is associated with an increase of CD3+ and CD8+ lymphocytes. The CD8+ increase is the only common significant alteration in the mucosa of both groups protected against the development of ulcerative colitis, suggesting that the factors causing changes in lamina propria lymphocytes of both groups are different.
Gastroenterología y Hepatología 02/2007; 30(2):57-60. · 0.73 Impact Factor
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ABSTRACT: To determine the diagnostic accuracy of computed tomography colonography (CTC) compared with conventional colonoscopy (CC).
Patients with an indication of CC were included. Fifty patients underwent CTC using multidetector CT before diagnostic colonoscopy was performed by an expert colonoscopist. Diagnostic accuracy was assessed individually both for each polyp and for each patient.
Fifty patients were included and 40 polyps were analyzed. The by-polyp sensitivity of CTC was 15% for polyps 5 mm or less, 75% for polyps 5- 10 mm and 75% for polyps 10 mm or larger. By-patient specificity was 6% for polyps 5 mm or less, 75% for polyps 5-10 mm and 80% for polyps 10 mm or larger. The specificity of CTC was 94%. CTC was preferred over CC by 90% of the patients. The mean colonoscopy examination time was 30 minutes for CC and 35 minutes for CTC (p < 0.05).
The sensitivity of CTC is moderate in detecting polyps larger than 10 mm, low in detecting 5-10 mm polyps and very low in detecting those less than 5 mm. The overall specificity of the procedure was 94%. Procedure time was lower with CC than with CTC but the latter was better tolerated by most patients.
Gastroenterología y Hepatología 30(7):375-80. · 0.73 Impact Factor
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ABSTRACT: Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 24 de Junio de 2009 Bibliografía 111-124
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ABSTRACT: Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Dpto. de Medicina. Fecha de lectura: 4 de Noviembre de 2009. Bibliografía
