한국인에서의 만성적 궤양을 동반하는 대장염에 대한 임상적 고찰

이풍렬,윤한두,김나영,정숙향,유권,정현채,이효석,윤용범,송인성,최규완,김정룡,최상운 대한내과학회 1990 대한내과학회지 Vol.38 No.3

The purpose of this study is to compare the differences of the symptoms, signs and laboratory findings among colitis with chronic ulceration, such as ulcerative colitis, Behcet's colitis, tuberculous colitis and Crohn's disease in Korea. Were studied in Seoul National University Hospital from August 1982 to Oocober 1988. Forty-two cases of ulcerative colitis, 23 cases of Behcet's colitis, 53 cases of tuberoulous colitis and four cases of Crohn's disease were analyzed in terms of age, sex, symptomatology, laboratory findings and consequence of treatment. 1) The sex ratio of ulcerative colitis, Behcet's, colitis tuberculous colitis and Crohn's disease was 1 : 1.63, 4.74 : 1, 1 : 1. 30, and 3 : 1, respectively, and the mean age was 36.1, 34.3, 33.4, 22.5 years, respectively. 2) The duration of symptoms in tuberculous colitis was significantly shorter than in other diseases. 3) The items of symptoms and signs showed that significant differences were rectal bleeding, diarrhea, weight loss, tenesmus, oral ulcer, skin lesion and genital ulcer. 4) The items of laboratory findings revealed that significant differences were anemia, increased ESR, hypoalbuminemia and the evidenoe of tuberculous lesion on chest X-ray. 5) In view of the anatomical distribution of the lesions, the rectums of all the cases were involved in ulcerative colitis. In most cases of Behcet's colitis and tubercuious colitis, the right colon, including the cecum and the ileum, was involved. In Crohn's disease, the ileum and the jejumum were frequently involved. 6) From a discriminant analysis, we could find several items that differentiated the four diseases. There were rectal bleeding, diarrhea, oral ulcer, hypoalbuminemia and evidence of tuberculosis on chest X ray.

What`s the Clinical Features of Colitis in Elderly People in Long-Term Care Facilities?

( So Yoon Yoon ),( Sung Ae Jung ),( Sun Kyung Na ),( Jae In Ryu ),( Hye Won Yun ),( Min Jin Lee ),( Eun Mi Song ),( Seong Eun Kim ),( Hye Kyung Jung ),( Ki Nam Shim ) 대한장연구학회 2015 Intestinal Research Vol.13 No.2

Background/Aims: As life expectancy has increased, the number of elderly patients who need long-term care has grown rapidly. Mortality in patients with colitis in long-term care facilities (LTCFs) is increasing. We intend to investigate the main causes of colitis in LTCFs compared to those of colitis in local communities, and to identify the clinical features and risk factors of patients with colitis in LTCFs. Methods: We retrospectively analyzed epidemiology, medical conditions, laboratory values, diagnoses, and clinical courses of elderly patients aged ≥65 who were admitted to the Ewha Womans University hospital with colitis between January 2007 and July 2012. Results: Patients with colitis in LTCFs (n=20) were compared with elderly patients with colitis in local communities (n=154). Fifty-five percent of colitis in LTCFs was caused by Clostridium difficile infection (CDI), 30% was due to ischemic colitis, and 15% was due to non-specific colitis. Non-specific colitis was the most common (63%) in the community group. Clinical outcomes were also significantly different between both groups: higher mortality (10.0% vs. 0.64%, P=0.021), higher requirement for intensive care units care (50.0% vs. 18.8%, P<0.01) in LTCFs group. In univariate analysis, the most significant risk factor for death in patients in LTCFs was decreased mental faculties. Conclusions: Patients in LTCFs showed worse clinical outcomes and a much higher prevalence of CDI compared to patients from local communities. We suggest early and active evaluation, such as endoscopic examination, for differential diagnosis in patients in LTCFs. (Intest Res 2015;13:128-134)

ORiginal Article : Cytokine Expression of Microscopic Colitis Including Interleukin-17

( Eunkyoung Park ),( Young Sook Park ),( Dae Rim Park ),( Sung Ae Jung ),( Dong Soo Han ),( Byung Ik Jang ),( Young Ho Kim ),( Won Ho Kim ),( Yun Ju Jo ),( Ki Ho Lee ),( Won Mi Lee ),( Eun Kyung Kim ) The Editorial Office of Gut and Liver 2015 Gut and Liver Vol.9 No.3

Background/Aims: Microscopic colitis is characterized by chronic watery diarrhea with specific pathological changes that can be diagnosed by microscopic examination. We performed immunohistochemical analysis of proinflammatory cytokines to investigate the pathogenic mechanism of microscopic colitis. Methods: This study consisted of six patients with lymphocytic colitis, six patients with collagenous colitis, and six patients with functional diarrhea but normal pathology. We performed an immunohistochemical analysis of the colonic mucosal biopsies to assess the expression of cyclo-oxygenase-2, interleukin-17, nuclear factor-κB, interferon-γ, inducible nitric oxide synthase, and tumor necrosis factor-α. We compared the quantity score of immunohistochemical staining among the groups. Results: The microscopic colitis group showed significantly higher expression of cyclo-oxygenase-2, interleukin-17, nuclear factor-κB, and interferon-γ compared with the control group. Cytokine expression was similar between collagenous colitis and lymphocytic colitis. However, the expression of cyclo-oxygenase-2 was higher in collagenous colitis. Conclusions: Proinflammatory cytokines, including interleukin-17 and interferon-γ, are highly expressed in microscopic colitis. The expression of cyclo-oxygenase-2 was higher in collagenous colitis than in lymphocytic colitis. This study is the first on interleukin-17 expression in microscopic colitis patients. (Gut Liver 2015;9:381-387)

허혈성 대장염에서 내시경 생검의 병리조직학적 소견

오영륜,박철근 대한병리학회 1999 Journal of Pathology and Translational Medicine Vol.33 No.7

궤양성 대장염에서 대장 점막 Mucin의 조직화학적 특성과 Lectin 반응

송근암(Geun Am Song),김태오(Tae Oh Kim),안진광(Jin Kwang An),이준홍(Jun Hong Lee),강대환(Dae Hwan Kang),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한내과학회 2000 대한내과학회지 Vol.58 No.5

N/A Backgrounds : In the pathogenesis of ulcerative colitis, a defective mucosal barrier to luminal antigens is currently under consideration, and alterations in mucin structure and lectin binding may play an important role in the defect of mucosal barrier. It is also, suggested that the differences in clinical manifestation and complication of ulcerative colitis are associated with the change in glycosylation of colonic mucus glycoconjugates. This study was performed in order to investigate the histochemical properties of the mucin in korean ulcerative colitis. Methods : The histochemical staining (HID-AB, mild PAS, PBT-KOH-PAS) and the binding of lectin (PNA, DBA, UEA-1, RCA-1, WGA, with avidin-biotin peroxidase complex method) to mucin glycoconjugates were analyzed in paraffin-embedded tissue sections obtained from 14 normal colons and 20 ulcerative colitis. Results : In the ulcerative colitis, number of goblet cell and amount of mucin were decreased, but the expression of its sulphomucin was consistently predominant and strong like normal colon. The expression of N-acetylated sialomucin was more common in the ulcerative colitis(80%) than normal colon(50%) and its grading mildly increased in ulcerative colitis. The expression of O-acetylated sialomucin was present in all cases of normal colon and its staining grade decreased in the ulcerative colitis. Compared to normal colonic mucosa, ulcerative colitis showed the increase in PNA and DBA binding in the supranuclear cytoplasm, the decrease in DBA and RCA-1 binding in the goblet cells, and no change in UEA-1 and WGA binding in both. In the ulcerative colitis, the increase in PNA and DBA binding was mild in the supranuclear cytoplasm and the expression of DBA and RCA-1 binding in goblet cells variably decreased. Conclusions : This study demonstrates the changes in the mucosal glycoconjugates between the ulcerative colitis and normal colon. The mucinous glycoconjugate expression of korean ulcerative colitis are different from that of western patients. There may be a genetic, racial variation in the glycoconjugate, which may also play a part in the differences in pathogenesis, clinical manifestation, and complication of ulcerative colitis.(Korean J Med 58:532-541, 2000)

Treatment of Dextran Sulfate Sodium-Induced Colitis with Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Inhibitor MI-2 Is Associated with Restoration of Gut Immune Function and the Microbiota

Lee, Kyung Won,Kim, Minseok,Lee, Chang Hoon American Society for Microbiology 2018 Infection and immunity Vol.86 No.12

<P><B>ABSTRACT</B></P><P>Disruption of the healthy intestinal microbiome and homeostasis of the intestinal immune system, which are closely interactive, are two key factors for ulcerative colitis. Here, we show that MI-2, a selective inhibitor of mucosa-associated lymphoid tissue lymphoma translocation-1 (MALT1), alleviated excessive inflammatory responses and was associated with restoration of healthy intestinal microbiome in mice suffering from dextran sulfate sodium (DSS)-induced colitis. We found that the diversity of intestinal microbiome of mice with DSS-induced colitis was significantly lower than that of healthy mice. However, MI-2 treatment in mice with DSS-induced colitis resulted in restored microbially diverse populations. To understand the possibility of the beneficial effect of the restored microbially diverse populations of MI-2-treated mice with DSS-induced colitis, we showed that inserting fecal microbiota from MI-2-treated mice with DSS-induced colitis and healthy control mice into mice with DSS-induced colitis could alleviate symptoms of colitis. The possibility of MI-2 treatment in DSS-induced colitis, associated with restoration of healthy microbially diverse populations in addition to reshaping host immune modulating capacity by reducing inflammatory cytokines (tumor necrosis factor alpha, interleukin-1β [IL-1β], IL-17α, and IL-22), may be considered therapeutic for ulcerative colitis.</P>

Daucosterol suppresses dextran sulfate sodium (DSS)-induced colitis in mice

Jang, Jin,Kim, Su-Man,Yee, Su-Min,Kim, Eun-Mi,Lee, Eun-Hee,Choi, Ha-Rim,Lee, Young-Sil,Yang, Won-Kyung,Kim, Han-Young,Kim, Kun-Hoae,Kang, Hyung-Sik,Kim, Seung-Hyung ELSEVIER 2019 INTERNATIONAL IMMUNOPHARMACOLOGY Vol.72 No.-

<P><B>Abstract</B></P> <P>The effects of daucosterol have been identified in cancer therapy and neuronal diseases. However, the regulatory function of daucosterol in DSS-induced colitis has not yet been investigated. In this study, we evaluated the immunological and therapeutic effects of daucosterol in a mouse model of dextran sulfate sodium (DSS)-induced colitis. Unlike vehicle mice, mice pre- or post-treated with daucosterol showed inhibition of body weight loss and the decrease in the disease activity index (DAI). In addition, daucosterol treatment rescued the DSS-induced decrease in colon length and disruption of the epithelial lining. Furthermore, it reduced DSS-induced production of reactive oxygen species (ROS), infiltration of macrophages, and expression of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β. Mice with colitis showed a decreased population of Foxp3<SUP>+</SUP> cells, which was upregulated by daucosterol treatment. Furthermore, daucosterol increased natural killer (NK) cell activity and inhibited excessive IgA levels in mice with DSS-induced colitis. Collectively, our findings demonstrated that daucosterol significantly alleviated DSS-induced colitis, indicating the possibility of daucosterol as a therapeutic option for colitis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Daucosterol prevented clinical symptoms of DSS-induced colitis. </LI> <LI> Daucosterol alleviated inflammation in DSS-induced colitis. </LI> <LI> Daucosterol recovered the number of Treg cells reduced by DSS-induced colitis. </LI> <LI> Daucosterol is good candidate therapeutic for colonic diseases including DSS-induced colitis. </LI> </UL> </P>

Protective effects of sigma 1 receptor agonist PRE084 on 2,4,6-trinitrobenzene sulfonic acid–induced experimental colitis in mice

Hyun Il Seo,권성춘,Jae Young Kwak 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.103 No.3

Purpose: We aimed to investigate the protective effect of sigma 1 receptor agonist and antagonist, PRE084 and BD1047, respectively, on 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. Methods: Thirty male ICR mice were randomly divided into 5 groups: control, 50% ethanol, colitis, PRE084 + colitis, and combined (PRE084 + BD1047 + colitis). Colitis was induced by intrarectal administration of TNBS. PRE084 and BD1047 were injected daily, starting 3 days before colitis induction. Distal colon tissue was excised for histopathological evaluation, and levels of glutathione (GSH), superoxide dismutase (SOD), myeloperoxidase (MPO), and lipid peroxidation were determined. Results: Colitis caused weight loss, mucosal damage, upregulation of tumor necrosis factor-α, interleukin (IL)-1β, IL- 6, MPO, and thiobarbituric acid reactive substance activities, and downregulation of GSH and SOD activities. These changes caused by TNBS-induced colitis were significantly ameliorated by PRE084 pretreatment. However, the combined pretreatment with BD1047 significantly attenuated the protective effect of PRE084, thereby reverting to the colitis-induced state. Conclusion: We conclude that the sigma 1 receptor agonist PRE084 exhibits significant protective effects against TNBS- induced colitis, which appears to be at least partly mediated by the inhibition of inflammation and oxidative stress, and enhancement of antioxidant properties. Collectively, these results suggest that PRE084 might be an effective drug for the treatment of ulcerative colitis.

Investigation of pulmonary involvement in in­flammatory bowel disease in an experimental model of colitis

( Bunyamin Aydin ),( Yıldıran Songur ),( Necla Songur ),( Oguzhan Aksu ),( Altug Senol ),( I Metin Ciris ),( Recep Sutcu ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.5

Background/Aims: Inflammatory bowel disease (IBD) may also involve various extra-intestinal organs. Clinical studies have found asymptomatic/symptomatic pulmonary involvement in 1% to 6% of patients with IBD. The present study his­topathologically investigated pulmonary involvement in an experimental model of colitis in order to demonstrate pulmonary tissue involvement in IBD and to expose potential etiological factors. It also explored the relation between inflam­mation and tissue concentrations of vascular endothelial growth factor (VEGF) and tumor necrosis factor α (TNF-α). Methods: The study comprised 24 male Wistar albino rats. The rats were divided into four groups of six rats each. Acute colitis was induced in two separate groups using either the dextran sulphate sodium (DSS) or trinitrobenzene sulfonic acid (TNBS) method, while the other two groups were used as controls for each model of colitis. Wallace scoring was used for macroscopic assessment of colitis, and the lungs were histopathologically examined. Concentrations of VEGF and TNF-α in pulmonary tissue were measured by the enzyme-linked immunosorbent assay method. Results: The number of animals that had alveolar hemorrhage was significantly higher in the TNBS induced colitis and DSS-induced colitis groups compared to their own control groups (p = 0.015 and p = 0.015, respectively). VEGF and TNF-α concentrations in pulmonary tissues were significantly increased in both the TNBS colitis and DSS colitis groups compared to their own control groups (p = 0.002 and p = 0.004, respectively; and p = 0.002 and p = 0.002, respectively). Conclusions: The present study demonstrated that significant and serious histo­pathological changes directly associated with colitis occur in the lungs in IBD.

Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study

오은혜,Kim Ye-Jee,Minju Kim,박승하,김태오,박상형 대한장연구학회 2023 Intestinal Research Vol.21 No.2

Background/Aims: We conducted a nationwide population-based study to investigate incidence rates of colorectal and biliary cancers according to accompanying primary sclerosing cholangitis in Korean ulcerative colitis patients. Methods: We used the Health Insurance Review and Assessment claim database from January 2007 to April 2020. Standardized incidence ratios of colorectal and biliary cancers in ulcerative colitis patients were calculated. Results: Among 35,189 newly diagnosed ulcerative colitis patients, 1,224 patients were diagnosed with primary sclerosing cholangitis. During the study period, 122 and 52 patients were diagnosed with colorectal and biliary cancers, respectively. Incidences of colorectal cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratios, 0.83; 95% confidence interval, 0.69–0.99), regardless of accompanied primary sclerosing cholangitis (standardized incidence ratio, 0.73; 95% confidence interval, 0.24–1.71). While incidences of biliary cancer were not higher in ulcerative colitis patients than those in the general population (standardized incidence ratio, 1.14; 95% confidence interval, 0.80–1.58), these were much higher with accompanied primary sclerosing cholangitis (standardized incidence ratio, 10.07; 95% confidence interval, 5.75–16.36). Cumulative incidences of colorectal and biliary cancers increased in patients who were diagnosed with ulcerative colitis at an older age. Conclusions: In Korean ulcerative colitis patients, colorectal cancer incidences were not higher than those in the general population regardless of accompanied primary sclerosing cholangitis. However, biliary cancer incidences were much higher in ulcerative colitis patients with primary sclerosing cholangitis than in those without, or in the general population.