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P126. Relationship between cytokine profile and local immunity in ulcerative colitis

J. Kaibullayeva, S. Abilaiuly, A. Nersesov

Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan

The aim of this study was to examine the relationship amongst immunological disorders in the colon, cytokine imbalance and spectrum of short-chain fatty acids in ulcerative colitis (UC).

Materials and Methods: 70 patients with UC were examined. The mean age was 35.7±1.4 years. Duration of disease was 35.0±5.58 months. The control group consisted of 20 patients with irritable bowel syndrome with the same sex and age. ELISA detection of secretory IgA in the intestinal juice, serum cytokines (IL-1RA, IL-4, IL-8, TNF-α and IFN-γ) and chromatographic study method of short-chain fatty acids in faeces were performed.

Results. The imbalance in the cytokine system, with more than two fold elevation of IL-4 in 32.3% of patients (p < 0.01) indicating the activation of humoral immune response initiated by T-helper type 2 was revealed. Direct correlation between acute course of UC and IL-4 (Mann-Whitney U = 80.0, p < 0.05) confirmed the involvement of this cytokine in the induction of immunoinflammatory processess.

The patients with UC had IFNγ/IL-4 index less than 1.0. Since IFNγ is produced by T-helper type 1 and IL-4 by T-helper type 2, the ratio between Th-1/Th-2 lymphocytes reflects the predominance of Th-2 type response.

Comparing the results of secretory IgA and clinical course features of UC the moderate inverse correlation between duration (r = −0.339, p = 0.07) and disease severity (coefficient Kendel W = −0.197, p < 0.05) was established.

The patients with UC showed the quantitative change in the composition of short-chain fatty acids, and reduction of shares of acetic, propionic and butyric acids (p < 0.001). The anaerobic index (the ratio of the sum of all acids, except acetic acid, to concentration of acetic) decreased to 0.52. The study found inverse correlation between chronic continuous flow and the level of butyric acid (U = 80.5, p < 0.05) and propionic acid (t-test = 2.4, p < 0.05). Also inverse relationship between the level of butyric acid and severity of UC (W = 0.226, p < 0.05) was found.

The inverse correlation relationship between chronic continuous flow and the level of oil (inverse weak, U = 80.0, p < 0.05) and propionic acid (a weak inverse, t = 2.4, p < 0.05) was revealed. The direct correlation among the level of secretory immunoglobulin A, the concentration of oil (r = 0.331, p < 0.05) and acetic acid (r = 0.253, p < 0.05) as evidence the influence of intestinal homeostasis on local immune response was found.

Conclusion. Insufficient production of short-chain fatty acid results in deficiency of secretory immunoglobulin A, reflecting an imbalance intestine immunocompetent system.

The increasing IL-4 level produced by T-helper type 2 indicates autoimmune mechanism of intestinal inflammation.