Genetic polymorphism in patients with early and late onset of ulcerative colitis.

OBJECTIVE: The aim was to investigate SNPs of TLR-2,3,4, NOD2/CARD15, JAK-2, and IL-10 in patients with the early and late UC onset. PATIENTS AND METHODS: Matherials and methods: 126 patients with UC were investigated. To assess the predisposition of the early and late UC onset the incidence of the following SNPs: Arg753Gln TLR2 gene, Phe412Leu TLR3 gene, Asp299Gly and Thr399Ile TLR4 gene, C-819T, G-1082A and C-592A gene IL-10, Val617Phe gene JAK2, Gly908Arg gene NOD2/CARD15 were analyzed. RESULTS: Results: 76 patients had early disease onset and 50 had a late one. SNPs of TLR3 were observed in 50.8% cases. TLR4 polymorphism was more common than TLR3, and was observed in 81 (64.3%) UC patients. Polymorphism of NOD2/CARD15 and IL-10 genes were revealed with almost the same frequency 49 (38.9%) and 50 (39.9%) patients, respectively. CONCLUSION: Conclusions: Polymorphisms of TLR-2,3 genes and TLR4 Asp299Gly, NOD2/CARD15 prevailed in patients with the late UC onset that allows to suppose that bacterial flora plays one of the key roles in modification of immune response and UC development. In patients with early UC onset polymorphisms of the JAK2 and IL-10 genes prevailed responsible for the cytokine cascade activation and cause the immune mechanism that might lead to a more aggressive course of the disease.

Clinical, endoscopical and morphological efficacy of mesalazine in patients with irritable bowel syndrome.

OBJECTIVES: The aim of this study was to analyze the clinical efficacy and cytomorphologic changes of colon mucosa following the treatment of patients suffering from irritable bowel syndrome (IBS) with mesalazine (5-aminosalicylic acid [5-ASA]). METHODS: In this controlled, randomized, blind clinical trial, a total of 360 patients with varying subtypes of IBS were randomly treated with 500 mg of mesalazine qid or by standard therapy without mesalazine for a period of 28 days. Pre- and post-treatment pain intensity, pain duration, meteorism, stool abnormalities and endoscopic parameters were monitored, and biopsies or brush biopsies were examined histologically. RESULTS: Treatment of IBS patients with mesalazine significantly reduced intensity and duration of pain in all subtypes of IBS, except for duration of pain in the subtype "undifferentiated", where the difference was not significant. In addition, in patients with diarrhea type and undifferentiated type of IBS, mesalazine also significantly reduced the abnormal stool pattern. In comparison to the control group, administration of mesalazine reduced the incidence of endoscopic and cytomorphologic changes of the bowel mucosa, including changes in colon mucus, mucus production, cytologic or histologic parameters, epithelial cell degeneration, appearance of leukocytes and macrophages and cell infiltrations. CONCLUSION: Mesalazine was effective in reducing several symptoms characteristic of IBS. It significantly reduced pain intensity and duration and improved cytohistologic parameters of the bowel mucosa.