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Markers of Inflammation and Lineage on Exfoliated Colonic Cells In Pediatric Inflammatory Bowel Disease | OMICS International | Abstract
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
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Case Report

Markers of Inflammation and Lineage on Exfoliated Colonic Cells In Pediatric Inflammatory Bowel Disease

Padmanabhan P. Nair1,2, Alka Kamra1, George Kessie1, Shilpa Kalavapudi1, June-Home Chen1, Robert Shores1, Lisa Madairos3, Alessio Fasano3 and Prasanna Nair4*
1NonInvasive Technologies, Elkridge, Maryland, USA
2Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
3Mucosal Biology Research Center and Division of Pediatric Gastroenterology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
4Division of General Pediatric Medicine, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
Corresponding Author : Prasanna Nair, MBBS, MPH, FAAP
Professor Emeritus, Department of Pediatrics
University of Maryland School of Medicine
Baltimore, Maryland 21201, USA
Tel: 410 328 2533
E-mail: [email protected]
Received November 15, 2011; Accepted December 14, 2011; Published December 16, 2011
Citation: Nair PP, Kamra A, Kessie G, Kalavapudi S, Chen J, et al. (2011) Markers of Inflammation and Lineage on Exfoliated Colonic Cells In Pediatric Inflammatory Bowel Disease. J Gastrointest Dig Syst S8:001. doi:10.4172/2161-069X.S8-001
Copyright: © 2011 Nair PP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objectives: The diagnosis (endoscopy, and biopsy) and continued clinical management of Inflammatory Bowel Disease (IBD), remain highly invasive, expensive, and inconvenient for the pediatric patient. The objective of this study was to see if colonocytes obtained from stools of subjects with IBD and normal controls would demonstrate higher levels of inflammatory markers (Cox 2 in CD45+ and CD45- cells) and if the inflammatory process and treatment effects would be reflected in an altered cytokine expression in the subjects compared to controls.   Setting: Outpatient hospital based pediatric gastroenterology clinic.   Methods and Main outcome measures: Stool samples (~ 1 gm), were obtained from 18 children between the ages of 4 and 18 diagnosed with IBD, and from a normal first degree relative. Colonocytes were isolated using the Somatic Cell Sampling Recovery (SCSR) system and assessed for the expression of COX-2, CD-45, IgA, IgG, IL6, IL18, TGF ß, TNF, and IL16ß using flow cytometry. In addition, levels of COX-2 and cytokeratin 19 transcripts were measured by microwell plate hybridization assay.   Results: Expression of COX-2 and co-expression of IgA and IgG were significantly higher in the IBD cases compared to the controls. In ulcerative colitis, the expression of COX-2 and co-expression of COX-2 and CD45 were greater than that in patients with Crohn’s disease. In contrast, cells expressing IgA and IgG were higher in Crohn’s. Subjects on immunosuppressants and/or anti-inflammatory medications, expressed significantly lower levels of COX-2 and IL-18 compared to those who were not on treatment.   Conclusions: This study indicates that the use of disease markers on exfoliated colonic cells can be used for noninvasive assessment of disease status, for follow-up of response to treatment and for forecasting flare-up of disease before its symptomatic manifestations.  
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