ABSTRACT
Crohn's disease and ulcerative colitis, both defined as inflammatory bowel diseases [IBD], are idiopathic inflammatory disorders of gut mucosa of unknown etiology. The clinical course of both diseases can differ from a mild form to a severe form. TNF- alpha is a key pro-inflammatory cytokine in IBD and in other chronic inflammatory conditions. A substantial amount of research has been conducted concerning TNF- alpha and anti-TNF- alpha therapies. Ghrelin, a hormone secreted from the stomach with orexigenic, adipogenic, and somatotropic properties, functions through the stimulation of its receptor, the growth hormone secretagogue receptor [GHS-R], leading to release of growth hormone. Although GHS-R and ghrelin are expressed in human T lymphocytes and monocytes, yet its role in regulation of immune responses remains undefined. was to study both ghrelin hormone and serum TNF-alpha in inflammatory bowel disease and their relation to degree of activity. The study included twenty patients with inflammatory bowel disease in varying degrees of activity and ten healthy volunteers were taken as control. All patients had undergone thorough clinical examination, calculation of body mass index, Ileocolonoscopy and biopsy, calculation of degree of disease activity, and measurement of serum Ghrelin hormone and serum TNF- alpha. The mean serum Ghrelin in IBD patients was significantly higher than in control group [802.4 +/- 51.14 versus 227.25 +/- 39.45 pg/ml respectively p=0.000]. Moreover, the mean serum ghrelin level in patients with moderate to severe activity was significantly higher than inatients with mild activity [828.89 +/- 32.48 versus778.91 +/- 55.11 pg/ml respectively] [p=0.012]. Also, Ghrelin hormone correlates positively with C-reactive protein. The mean serum TNF-alpha level was significantly higher in patients than in control group [60.20 +/- 59.86 versus 22.2 +/- 15.70 ng /ml respectively p=0.007]. The mean TNF- alpha level for patients with mild activity was 53.36 +/- 52.27 and was 68.56 +/- 70.37 for patients with moderate to severe activity, with no statistically significant difference between the two groups [p=0.299]. Serum ghrelin hormone increases significantly in IBD than in control group and correlates positively with the degree of IBD activity, while serum TNF-alpha,although significantly increased in patients with IBD yet it doesn't correlate statistically with disease activity