Daferera N, Kumawat AK, Hultgren-Hörnquist E, Ignatova S, Ström M, Münch A. Fecal stream diversion and mucosal cytokine levels in collagenous colitis: A case report. World J Gastroenterol 2015; 21(19): 6065-6071 [PMID: 26019474 DOI: 10.3748/wjg.v21.i19.6065]
Corresponding Author of This Article
Andreas Münch, MD, PhD, Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden. andreas.munch@lio.se
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Gastroenterol. May 21, 2015; 21(19): 6065-6071 Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.6065
Fecal stream diversion and mucosal cytokine levels in collagenous colitis: A case report
Niki Daferera, Ashok Kumar Kumawat, Elisabeth Hultgren-Hörnquist, Simone Ignatova, Magnus Ström, Andreas Münch
Niki Daferera, Magnus Ström, Andreas Münch, Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden
Ashok Kumar Kumawat, Elisabeth Hultgren-Hörnquist, School of Health and Medical Sciences, Örebro University, 70182 Örebro, Sweden
Simone Ignatova, Department of Pathology, Linköping University, 58185 Linköping, Sweden
Author contributions: Daferera N and Münch A contributed equally to this work; Kumawat AK, Münch A and Hultgren-Hörnquist E designed the research; Kumawat AK and Ignatova S performed the research; Daferera N, Münch A, Ström M, Ignatova S and Hultgren-Hörnquist E analyzed the data; and Daferera N wrote the paper.
Ethics approval: The study was reviewed and approved by the regional Ethical Committee of Linkoping, Sweden (Dnr 2012/216-31).
Informed consent: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest: Andreas Münch has received fees for serving as a speaker for dr Falk Pharma and a research grand from Abbott. The rest of the co-authors have no conflict of interest.
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/
Correspondence to: Andreas Münch, MD, PhD, Division of Gastroenterology and Hepatology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden. andreas.munch@lio.se
Telephone: +46-10-1030000 Fax: +46-10-1033896
Received: October 27, 2014 Peer-review started: October 28, 2014 First decision: November 14, 2014 Revised: December 3, 2014 Accepted: January 30, 2015 Article in press: January 30, 2015 Published online: May 21, 2015 Processing time: 205 Days and 12 Hours
Core Tip
Core tip: The pathophysiology of collagenous colitis remains poorly understood. We describe a patient with chronic, active collagenous colitis who either failed to achieve clinical remission or experienced adverse effects with all medications given; therefore the patient was treated with a temporary loop ileostomy. We analyzed cytokine protein production with Luminex assays in colonic biopsy tissues obtained before and during fecal stream diversion (FSD) and after intestinal continuity was restored. Because FSD leads to clinical and histological remission, this study protocol provided a unique opportunity to study cytokine dynamics during different stages of disease. We were thus able to demonstrate that FSD was followed by a decrease in the levels of nearly all cytokines and that the restoration of bowel continuity increased the levels of the proinflammatory cytokines interleukin IL-2, IL-21 and IL-23.
