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P059. Immunohistochemical expression of angiopoietin 1 (Ang1), CD34 and D2.40 in colon of patients with inflammatory bowel disease (IBD) and its association with endoscopic activity

P.M. Linares1, M.E. Fernández-Contreras1, A. Algaba2, M. Guijarro Rojas3, F. Bermejo2, M. Chaparro1, J.P. Gisbert1, 1Hospital Universitario de la Princesa-IP, Gastroenterology and CIBEREHD, Madrid, Spain, 2Hospital Universitario de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain, 3Hospital Universitario de la Princesa-IP, Pathology, Madrid, Spain

Background

Increasing evidence suggests a role of angiogenesis in inflammatory bowel disease (IBD). To explore its relation with the presence and endoscopic activity of ulcerative colitis (UC) and Crohn's disease (CD), the density of microvessels (MV) expressing angiogenic (CD34 and Ang1) and lymphangiogenic (D2.40) factors in colon mucosa of patients with and without IBD was assessed.

Methods

Biopsies from patients with and without IBD subjected to colonoscopy by medical criteria were studied by immunohistochemistry. Positive MV (+MV) were measured by direct count in four fields at 40X magnification. Endoscopic activity was classified as active or inactive disease by the Mayo Subscore (UC) and the SES-CD index (CD). In patients with endoscopic activity, biopsies were taken from inflamed and non-inflamed mucosa.

Results

101 biopsies from 58 patients with IBD (36 UC and 22 CD) and 19 patients with normal mucosa were included. 48% cases had active disease. The mean age of the studied subjects was 41±14 years, 61% were female. MV expressing the three studied markers were more numerous in samples from IBD patients (P < 0.01; Table 1).

By type of IBD, D2.40+ and Ang1+MV density was similar in CD and control samples, and only CD34+MV were significantly elevated (27.3±10 vs 21.1±8; P = 0.04). When comparing CD vs UC, D2.40+ and Ang1+MV densities were higher in the UC group (P = 0.03 and 0.006) but CD34+MV count was similar. Endoscopic IBD activity was associated to Ang1 (P = 0.002; Table 2) a similar trend being observed for D2.40. Within the UC group, CD34+MV density tended to be slightly higher in samples without endoscopic activity, compared to actives (32.3±1 vs 27.2±12; P = 0.1).

Table 1
 D2.40*PCD34*PAng1*P
Non-IBD1.5±1.1 21.1±8.3 31.7±6.0 
UC5.1±3.70.0130.3±11.50.00848.3±17.40.0001
CD3.1±3.6 27.3±10.5 36.3±14.8 
*Mean (ng/ml ±SD); SD: Standard deviation.
Table 2
 D2.40*PCD34*PAng1*P
Inactive3.9±3.40.130.4±10.80.338.5±13.30.002
Active5.3±4.1 27.9±11.8 51.9±19.6 
*Mean (ng/ml ±SD); SD: Standard deviation.

Conclusion

Ang1 and D2.40 seem to be associated to UC. In CD samples, only CD34+MV count was higher than in controls. Ang1 was a marker of endoscopical IBD activity. Our findings support an involvement of angiogenesis in IBD, but suggest a different role of the studied markers in UC and CD.