The Nature of Colitis in Chronic Granulomatous Disease
Michela G. Schäppi
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorNigel J. Klein
Department of Immunology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorKeith J. Lindley
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorDyanne Rampling
Department of Histopathology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorVirpi V. Smith
Department of Histopathology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorDavid Goldblatt
Department of Immunology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorCorresponding Author
Peter J. Milla
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Address correspondence to Professor Peter J. Milla, Gastroenterology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH (e-mail: [email protected]).Search for more papers by this authorMichela G. Schäppi
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorNigel J. Klein
Department of Immunology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorKeith J. Lindley
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorDyanne Rampling
Department of Histopathology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorVirpi V. Smith
Department of Histopathology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorDavid Goldblatt
Department of Immunology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Search for more papers by this authorCorresponding Author
Peter J. Milla
Departments of Gastroenterology, Institute of Child Health and Great Ormond Street Hospital, London, UK
Address correspondence to Professor Peter J. Milla, Gastroenterology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH (e-mail: [email protected]).Search for more papers by this authorABSTRACT
Background
Patients with chronic granulomatous disease (CGD) may have gastrointestinal manifestations, commonly colitis. The etiology, prevalence, and inflammatory process of CGD colitis are unclear.
Objectives
To characterize the inflammatory process of CGD colitis and to compare it with other inflammatory bowel disorders.
Methods
Colonic mucosal biopsies from 8 CGD patients were immunostained for eosinophils, neutrophils, macrophages, and adhesion molecules (ICAM; VCAM, E-selectin) and compared with normal and diseased controls (allergic colitis, ulcerative colitis, and melanosis coli). Cell types were counted and expressed as cell/mm2
Results
The inflammatory infiltrate in CGD colitis differed from the normal controls by an increase in eosinophils (110; 48–176 [median and range] versus 14.5; 3–30;P < 0.005) and macrophages (291.5; 203–480 versus 38.5; 27–64;P < 0.005). There was a paucity of neutrophils compared to ulcerative colitis (10; 0–101 versus 315.5; 78–688;P < 0.005). Expression of HLA-DR was increased in the epithelium and vascular endothelium in CGD compared with normal controls. Patterns of expression of the adhesion molecules differed significantly in CGD from those in other inflammatory bowel diseases: intracellular adhesion molecule-1 was more strongly expressed in the lamina propria, vascular adhesion molecule-1 was more patchily expressed, and E-selectin was present only in the small vessels.
Conclusions
The mechanism of inflammation and profile of inflammatory mediators in CGD colitis differs from that in other inflammatory bowel diseases.
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