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* = Presenting author

P424 Th1 and Th17 response in relation with steroid response in Crohn's disease

A. Carrasco*, F. Fernández-Bañares, Y. Zabana, M. Aceituno, M. Rosinach, X. Andújar, C. Loras, R. Temiño

Hospital Universitari Mútua Terrassa, UB, Gastroenterology, Terrassa, Spain

Background

Th1 and Th17 cells are increased in the mucosa of inflammatory bowel disease (IBD) patients. In Crohn's Disease (CD) peripheral Th17 cells are increased in late patients compared with newly diagnosed (Veny et al 2010). Increased Th17 cells are also increased in the mucosa of the anastomosis in operated patients after recurrence (Zorzi et al 2013). Therefore, Th17 cells increase seems to be related with the perpetuation of inflammation and the lack of response of medical treatments, and could be useful for steroid response prediction.

Aim: Assess usefulness of Th1 and Th17 cells as steroid response predictors.

Methods

21 CD patients (5 sensitive, 6 dependent and 5 refractory to steroids, and 7 refractory to all treatments), 7 ulcerative colitis (UC) and 20 healthy controls (HC) were included. Inflammatory bowel disease patients were included with active disease and before steroid administration. No patient were taking immunossuppresants (IIMs) or biologics. CD was considered disabling when there was a need for IMMs or biologics for disease control during the following 3 years follow-up (Th1 and Th17 cells were determined in mucosal and peripheral blood lymhocytes in unstimulated and stimulated (PMA/Ionomycin/Brefeldin-A) cultures with intracellular staining (IFN and IL117A) and flow cytometry.

Results

An increase in mucosalIFN (p=0.000) and IL17A (p=0.000) CD3+CD4+ producer cells was detected in CD patients compared to controls, in both stimulated and unstimulated cultures, but no differences were detected in relation to steroid response or the presence of disabling disease. In ulcerative colitis, an increase in mucosal IL17A CD3+CD4+ producing cells (p=0.031) was detected only in stimulated culture in comparison with HC.An increase in CD3+IFN+ (p=0.007), CD3+CD4+IFN+ (p=0.024) and CD3+IL17A+ (p=0.014) peripheral cells was detected in CD patients compared to controls. CD3+ IFN producing peripheral T cells from unstimulatedculture were increased in dependent and refractory patients in comparison to steroid responders (p=0.024)

Conclusion

A Th1 and Th17 response in CD was confirmed. A higher peripheral Th1 response in steroid refractoriness was found, but not discriminative enough to be used for diagnostic purposes.