Ülseratif kolitli çocukların intestinal mukozasında FOXP3+ Treg hücreleri ve interlökin-23 ekspresyonu

Öz

Amaç

Ülseratif kolitin (UK), anormal immün yanıt sonucu geliştiği düşünülmektedir. Forkhead box P3 (FOXP3) T regülatuvar (Treg) hücreleri ve interlökin (IL)-23/T-helper 17 yolağı, inflamatuvar bağırsak hastalığının patogenezinde önemli bir rol oynamaktadır. Ancak bu yolağın UK'li çocuklardaki rolü ile ilgili bilgilerimiz sınırlıdır. Bu çalışmanın amacı UK’li çocukların bağırsak mukozasında FOXP3 ve IL-23’ün düzeylerinin belirlenerek, hastalığın patogenezindeki rollerinin araştırılmasıdır.

Gereç ve yöntemler

Yirmi dokuz UK’li hasta (18 pankolit, dokuz sol kolon tutulumlu ve iki proktokolit) ve 11 kontrol hastası çalışmaya dahil edildi. İmmünohistokimyasal boyama yöntemi ile, UK hastaların inflamasyonlu dokularından ve kontrol hastalarının inflamasyon içermeyen dokularından alınan biyopsi örneklerinde FOXP3⁺ Treg hücreleri ve IL-23 düzeyleri incelendi.

Bulgular

Ülseratif kolitli hastalarda  FOXP3⁺ Treg hücre seviyesi kontrol grubuna göre önemli oranda yüksekti (%45.67 ± 10.83 ve %22.06 ± 8.09, p=0.007). IL-23 düzeyi de UK hastalarında kontrol grubuna göre anlamlı olarak yüksekti (24.33% ± 13.81 vs. 12.91% ± 5.06, p=0.009). Pankolitli hastalarda FOXP3⁺ Treg hücreleri (%43.21 ± 16.97) ve IL-23 (%25.12 ± 14.98) ekspresyonu kontrol grubundan daha yüksek olduğu görüldü (p=0.012 ve p=0.022). Ancak, kontrol grubu ile sol kolon tutulumu ve proktokoliti olan hastalar arasında FOXP3⁺ Treg hücreleri ve IL-23 ekspresyonunda farklılık bulunmuyordu.

Sonuçlar

Ülseratif kolitli çocukların bağırsak mukozalarında FOXP3⁺ Treg hücreleri ve IL-23 ekspresyonu daha yüksek olduğu tespit edildi. Bu sonuçlar, IL-23 yolağını engellemeye ve Treg hücre sayılarını yükseltmeye yönelik yeni tedavi seçeneklerin, UK'in daha etkili bir şekilde tedavi edilmesine yardımcı olabileceğini göstermektedir.

Anahtar Kelimeler

• Ülseratif kolit,Çocuk,İnterlökin-23,FOXP3,Sitokin

FOXP3+ Treg cells and interleukin-23 expression in the intestinal mucosa of children with ulcerative colitis

Öz

Background/Aims

Ulcerative colitis (UC) is thought to result from an aberrant immune response. Forkhead box P3 (FOXP3) regulatory T (Treg) cells and Interleukin (IL)-23/T-helper 17 pathway play an important role in the pathogenesis of inflammatory bowel disease, but little is known about their role in children with UC. The aim of this study was to investigate the role of FOXP3 and IL-23 in the pathogenesis of UC by determining them in intestinal tissues of children with the disease.

Materials and Methods

We studied 29 patients with UC (18 pancolitis, nine left-sided colitis, and two proctocolitis) and 11 control subjects. Immunohistochemistry was used to examine FOXP3⁺ Treg cells and IL-23 in intestinal biopsy specimens from UC patients and from non-inflamed tissues in the control group.

Results

UC patients’ FOXP3+ Treg cells were significantly higher than those of the control group (45.67% ± 10.83 vs. 22.06% ± 8.09, p=0.007). IL-23 expression in patients with UC were significantly higher than those of the control subjects (24.33% ± 13.81 vs. 12.91% ± 5.06, p=0.009). FOXP3+ Treg cells (43.21% ± 16.97) and IL-23 (25.12% ± 14.98) expression in patients with pancolitis were higher than in the control group (p=0.012 vs p=0.022). However, no differences were determined in FOXP3⁺ Treg cells and IL-23 in patients with left colon involvement and proctocolitis compared to the control group.

Conclusions

FOXP3⁺ Treg cell and IL-23 expression were higher in the intestinal mucosa of children with UC. These data indicate that new therapeutic options directed toward inhibiting the IL23 pathway and raising Treg cell numbers may permit more efficacious treatment of UC.

Anahtar Kelimeler

• Ulcerative colitis; children; interleukin-23; FOXP3; cytokine

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