Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2019; 25(43): 6465-6482
Published online Nov 21, 2019. doi: 10.3748/wjg.v25.i43.6465
Metabolic syndrome attenuates ulcerative colitis: Correlation with interleukin-10 and galectin-3 expression
Marina Jovanovic, Bojana Simovic Markovic, Nevena Gajovic, Milena Jurisevic, Aleksandar Djukic, Ivan Jovanovic, Nebojsa Arsenijevic, Aleksandra Lukic, Natasa Zdravkovic
Marina Jovanovic, Natasa Zdravkovic, Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Bojana Simovic Markovic, Nevena Gajovic, Ivan Jovanovic, Nebojsa Arsenijevic, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Milena Jurisevic, Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Aleksandar Djukic, Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Aleksandra Lukic, Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
Author contributions: Jovanovic M, Jovanovic I, Djukic A and Zdravkovic N designed the study; Jovanovic M, Simovic Markovic B and Gajovic N performed the study; Jovanovic M, Simovic Markovic B and Gajovic N collected data; and Jovanovic I, Gajovic N and Jovanovic M analyzed data; Jovanovic M, Lukic A, Arsenijevic N and Jovanovic I wrote the paper; All authors discussed the results and implications and commented on the manuscript at all stages.
Institutional review board statement: The study was reviewed and approved by the Clinical Center of Kragujevac and Faculty of Medical Sciences, University of Kragujevac, Serbia Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest to be reported.
Data sharing statement: All data used to support the findings of this study are included within the article. Technical appendix, statistical code, and dataset available from the corresponding author at bojana.simovicmarkovic@medf.kg.ac.rs.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bojana Simovic Markovic, MD, PhD, Research Assistant Professor, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia. bojana.simovicmarkovic@medf.kg.ac.rs
Telephone: +381-34-306800 Fax: +381-34-306800
Received: July 25, 2019
Peer-review started: July 25, 2019
First decision: August 27, 2019
Revised: October 24, 2019
Accepted: November 7, 2019
Article in press: November 7, 2019
Published online: November 21, 2019
Processing time: 118 Days and 18.9 Hours
Abstract
BACKGROUND

Ulcerative colitis (UC) is a chronic disease characterized by inflammation of intestinal epithelium, primarily of the colon. An increasing prevalence of metabolic syndrome (MetS) in patients with UC has been documented recently. Still, there is no evidence that MetS alters the course of the UC.

AIM

To test the influence of the MetS on the severity of UC and the local and systemic immune status.

METHODS

Eighty nine patients with de novo histologically confirmed UC were divided in two groups, according to ATP III criteria: Group without MetS (no MetS) and group with MetS.

RESULTS

Clinically and histologically milder disease with higher serum level of immunosuppressive cytokine interleukin-10 (IL-10) and fecal content of Galectin-3 (Gal-3) was observed in subjects with UC and MetS, compared to subjects suffering from UC only. This was accompanied with predomination of IL-10 over pro-inflammatory cytokines tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interleukin-17 (IL-17) in the sera as well as Gal-3 over TNF-α and IL-17 in feces of UC patients with MetS. Further, the patients with both conditions (UC and MetS) had higher percentage of IL-10 producing and Gal-3 expressing innate and acquired immune cells in lamina propria.

CONCLUSION

Local dominance of Gal-3 and IL-10 over pro-inflammatory mediators in patients with MetS may present a mechanism for limiting the inflammatory process and subsequent tissue damage in UC.

Keywords: Ulcerative colitis; Metabolic syndrome; Galectin-3; Inflammation; Interleukin-10; Systemic immune response

Core tip: Metabolic syndrome (MetS) is among most common ulcerative colitis (UC) comorbidity. Still, there is no data considering whether the comorbidity of UC and MetS affects the pathology of UC. The aim of this study was to investigate the effects of MetS on severity and immunopathology of UC. Our results revealed that patients with MetS have milder form of UC accompanied with higher level of Galectin-3 and interleukin-10 and altered functional phenotype and intracellular content of lymphocytes infiltrating affected tissue.