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Gut 2000;46:40-45 doi:10.1136/gut.46.1.40
  • Small intestine

Diversion of intestinal flow decreases the numbers of interleukin 4 secreting and interferon γ secreting T lymphocytes in small bowel mucosa

  1. A Schmita,
  2. A Van Gossumb,
  3. M Carola,
  4. J-J Houbenc,
  5. F Mascarta
  1. aDepartment of Immunology, Erasme University Hospital, Free University of Brussels, Route de Lennik, 808, B-1070 Belgium, bDepartment of Gastroenterology, Erasme University Hospital, cDepartment of Digestive Surgery, Erasme University Hospital
  1. Dr F Mascart.
  • Accepted 3 August 1999

Abstract

BACKGROUND/AIMS The intestinal immune system faces large amounts of antigens, and its regulation is tightly balanced by cytokines. In this study, the effect of intestinal flow diversion on spontaneous secretion of interleukin (IL)-4 and interferon (IFN)- γ was analysed.

METHODS Eight patients (two with Crohn's disease, four with ulcerative colitis, and two with previous colon cancer) carrying a double lumen small bowel stoma after a total colectomy procedure were included in the study. For each patient, eight biopsy samples were taken endoscopically from both the diverted and non-diverted part of the small bowel. Intraepithelial lymphocytes (IELs) and lamina propria lymphocytes (LPLs) were isolated separately and assayed for numbers of cells spontaneously secreting IL-4 and/or IFN-γ by an ELISPOT technique.

RESULTS Compared with the non-diverted mucosa, a significant decrease in the number of spontaneously IFN-γ secreting CD3 lymphocytes was observed in the diverted small bowel mucosa among both IELs (p = 0.008) and LPLs (p = 0.007). The same results, although less significant, were obtained for IL-4, especially in LPLs (p = 0.01).

CONCLUSION The intestinal content influences the spontaneous secretion of IFN-γ and IL-4 by intestinal lymphocytes. These results could help to elucidate the anti-inflammatory role of split ileostomy in patients suffering from inflammatory bowel diseases.

Footnotes

  • Abbreviations used in this paper:
    IL
    interleukin
    IFN
    interferon
    TNF
    tumour necrosis factor
    IEL
    intraepithelial lymphocyte
    LPL
    lamina propria lymphocyte
    ELISPOT
    enzyme linked immunospot technique

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