Increased rectal mucosal expression of interleukin 1β in recently acquired post-infectious irritable bowel syndrome

Gwee, K.-A.; Collins, S.M.; Read, N.W.; Rajnakova, A.; Deng, Y.; Graham, J.C.; McKendrick, M.W.; Moochhala, S.M.
April 2003
Gut;Apr2003, Vol. 52 Issue 4, p523
Academic Journal
Background and aims: Chronic bowel disturbances resembling irritable bowel syndrome (lBS) develop in approximately 25% of patients after an episode of infectious diarrhoea. Although we have previously shown that psychosocial factors operating at the time of, or prior to, the acute illness appear to predict the development of post-infectious lBS (PI-lBS), our finding of an increased inflammatory cell number in the rectum persisting for at least three months after the acute infection suggested that there is also an organic component involved in the development of PI-lBS. To evaluate this further, we measured expressions of interleukin 1β (IL-1β) and its receptor antagonist (IL-1 ra) in these patients to provide additional evidence that the pathogenesis of PI-lBS is underpinned by an inflammatory process. Methods: Sequential rectal biopsy samples were prospectively obtained during and three months after acute gastroenteritis, from eight patients who developed post-infectious lBS (INF-IBS) and seven patients who returned to normal bowel habits after acute gastroenteritis (infection controls, INF-CON). Eighteen healthy volunteers who had not suffered from gastroenteritis in the preceding two years served as normal controls (NOR-CON). IL-1β and IL-1ra gene expressions were assayed by reverse transcriptase-polymerase chain reaction, and their levels of expression were quantitated by optical densitometry after electrophoresis on agarose gel. Results: INF-IBS patients exhibited significantly greater expression of IL-1β mRNA in rectal biopsies than INF-CON patients both during and three months after acute gastroenteritis. Moreover, IL-1β mRNA expression had increased in biopsies taken from INF-IBS patients at three months after the acute infection but no consistent change was observed in INF-CON patients. IL-1β mRNA expression of INFlBS patients at three months post gastroenteritis was significantly greater than NOR-CON whereas that of...


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