Abstract
Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease, characterized by alternating stages of clinically active and inactive disease. UC exhibits several inflammatory characteristics, including immune activation, leukocyte infiltration, and altered vascular density. In UC, many of the upregulated inflammatory cytokines are proangiogenic and are released by diverse cell populations, such as infiltrating immune cells and endothelial cells (EC). Increasing evidences suggest that neovascularisation may involve also endothelial progenitor cells (EPCs). In this study we evaluated EPCs recruitment and homing, assessed by CXCR4 expression, in both acute and remitting phase of UC. We report an overall decrease of EPCs in UC patients (controls = 97,94 ± 37,34 cells/mL; acute = 31,10 ± 25,38 cells/mL; remitting = 30,33 ± 19,02 cells/mL; P < 0.001 for both UC groups versus controls). Moreover CXCR4+-EPCs, committed to home in inflammatory conditions, were found to be reduced in acute UC patients compared to both remitting patients and controls (acute = 3,13 ± 4,61 cells/mL; controls = 20,12 ± 14,0; remitting = 19,47 ± 12,83; P < 0,001). Interestingly, we found that administration of anti-inflammatory drugs in acute UC is associated with an increase in circulating EPCs, suggesting that this therapy may exert a strong influence on the progenitor cells response to inflammatory processes.
Highlights
Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease (IBD), classically characterized by alternating stages of clinically active and inactive disease, a pattern seen in 80–90% of patients [1, 2]
In this study we confirmed that UC patients in the remitting phase show a consistent reduction of the circulating levels of endothelial progenitor cells (EPCs) [15]
This effect was not investigated in course of the acute phase of UC
Summary
Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease (IBD), classically characterized by alternating stages of clinically active and inactive disease, a pattern seen in 80–90% of patients [1, 2]. According to population-based studies, an intermittent course of the disease occurs in 40– 65% of patients after the first disease flare, whereas a continuous course of active disease may be seen in 5–10% of patients [3, 4]. Clinical presentation can be limited to the rectum in cases of proctitis or may involve the sigmoid colon with or without descending colon in left-sided colitis. A few patients may develop limited terminal ileal involvement that can be difficult to differentiate from Crohn’s ileocolitis. Severe symptoms are less commonly seen with left-sided colitis and proctitis.
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