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Immunological responses following surgery in ulcerative colitis

Patel, Rajan Kumar (1995)
M.D. thesis, University of Birmingham.

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The role of serum autoantibodies, soluble adhesion molecules, plasma and mucosal cytokines were studied following surgery for ulcerative colitis (UC). A high prevalence of ANCA was found in UC but not in Crohn’s disease. ANCA positive UC sera were found to recognise a variety of antigens, namely lactoferrin, cathepsin G, enolase and elastase. Confocal microscopy revealed maximum immunofluorescence for P-ANCA to emanate from the intranuclear and not the extra-(peri) nuclear portion of the neutrophil, as currently believed. AECA, like ANCA, are also found in UC, suggesting immunological similarities with systemic vasculitis. Perhaps, UC represents a gut limited vasculitis. Persistance of ANCA, AECA, anti-EPI and antitropomyosin antibodies in the sera, several years following total colectomy, suggests that immunological mechanisms are not halted, by total colectomy. Soluble intercellular cell adhesion molecules, ICAM-1 and E-Selectin, but not VCAM-1, were found to be useful markers of disease activity in UC. Plasma levels of cytokines do not reflect disease activity, however, there is similar quantitative expression of pro-inflammatory cytokines by isolated mucosal mononuclear cells in both active UC and pouchitis, but not in nonspecific proctitis, which seems to suggest that pouchitis is not merely a complication of ileoanal pouch surgery but, that it represents reactivation of UC in ileal mucosa, which has undergone villous atrophy and colonic metaplasia.

Type of Work:M.D. thesis.
School/Faculty:Faculties (to 1997) > Faculty of Medicine and Dentistry
Department:Department of Surgery
Subjects:RD Surgery
QR180 Immunology
Institution:University of Birmingham
Library Catalogue:Check for printed version of this thesis
ID Code:33
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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