Role of Interleukin-13 ( IL 13 ) , Natural Killer ( NK-CD57 ) Cells and Non Neural Acetyl Choline ( NNAC ) in Patients with Fusobacterium Varium Colonized Ulcerative Colitis in Specialized Medical Hospital ( SMH )

Ibrahim Elmorsy; ElWakeel , G. A.; Monir Bahgat

doi:10.12816/0004900

Article Details

Role of Interleukin-13 ( IL 13 ) , Natural Killer ( NK-CD57 ) Cells and Non Neural Acetyl Choline ( NNAC ) in Patients with Fusobacterium Varium Colonized Ulcerative Colitis in Specialized Medical Hospital ( SMH )

Authors:

Ibrahim Elmorsy | ElWakeel , G. A. | Monir Bahgat

Publisher:

The Egyptian Society of Medical Microbiology

Main Topics:

Medicine

Journal:

The Egyptian Journal of Medical Microbiology 2012 Vol.21 Issue 3, pp.125-136

Document Type:

Article

Publication Date:

7/2012

Document Language:

English

Document ID (Org No.):

49053

Frequency:

Quarterly

pISSN:

11102179

DOI:

10.12816/0004900

Descriptors:

Abstract:

 Introduction: The role of IL-13 and mucosal Natural Killer (NK-CD 57) cells, in inducing and/or increasing severity or relapses of Ulcerative Colitis (UC), is still controversial; Whereas some studies describe the protective role of IL-13 and NK cells in UC as major mucosal defense elements, many others confirm that IL-13 and NK particularly, CD 57 cells, react in an abnormal fashion that induces dysboisis “defined as quantitative and qualitative microbial imbalance in the gut” therefore, increasing severity of UC, especially with underlying infection. The colonization of Fusobacterium varium which produces cyto-toxins and various organic acids, mainly butyric acid and its association with high levels of mucosal IL-13 and NK was also found to be a major factor associated with development and progression of the course the of disease leading to severe degrees of ulcerations. The aim of our study is to find the correlation between levels of mucosal and blood IL-13 and NK cells particularly CD57 cells and the colonizing Fusobacterium varium via, isolating the pathogenic bacteria from inflamed mucosa of 86 studied patients with various degrees of UC and to examine whether the bacteria produce cyto-toxins and organic acids also, determine levels of non neural acetyl choline (NNAC) secretions involved in increased colonic motility, in an attempt to better understanding the immunopathology of the disease. Results: According to our study, Fusobacterium varium was isolated from (44.18%) of cases of which, (78.9%) produced cyto-toxin (vero-toxin) and, (94.7%) produced organic acids that are pathologically involved in damaging the mucus membrane in UC. Among the total of 86 studied patients, high concentrations of serum and mucus levels of IL-13 (42.8% and 64.9% respectively) were significantly associated with severe cases of UC than in mild or moderate cases; Moreover, total serum IL-13 was elevated in (32.56%) of all studied patients, also was elevated in mucus (43%) in the same patients; Whereas serum and mucus IL-13 was significantly higher among patients colonised with Fusobacterium varium (73.7% and 97.4%, respectively), which confirms recent studies that IL-13 plays an important role in disruption of colonic mucosa and hence contribute to the development and/or of the relapses of UC, especially severe cases. In the same multi-variant analysis, our study showed significant increase in NK-CD57 in both blood and inflamed mucosa, in moderate (31.25% and 27%, respectively) and in severe cases (43.74% and 54%, respectively), than in mild cases. Also total NK-CD57 in blood and mucosa was elevated in (37.2% and 43%, respectively) of all studied patients; Whereas blood and mucosal NK-CD57 levels were significantly higher among patients colonised with Fusobacterium varium (84.21% and 97.4%, respectively). There was a remarkable improvement of clinical signs and symptoms after a 14 days use of imipenem and two months course of treatment with steroids, infliximab, probiotics and fluids and the number of isolated Fusobacterium varium, its verotoxin and organic acids production were reduced remarkably. Concurrently the levels of IL-13 in mucosa and blood were also, decreased markedly which gives no doubt that IL-13 is a major cytokine associated with severe cases of UC course of disease. Surprisingly enough, the levels of NK cells (CD57); both in blood and mucosa remained high across the course of the disease, before and after treatment, especially among severe cases, which suggests that IL-13 secretion was either, NK-CD57 independent in the first place or its secretion was suppressed with steroids. Also suggests that the persistence of NK-CD57 might still be required to produce other cytokines involved in the inflammatory process and might even play a crucial role in remissions especially when treatment has stopped. Increased colonic motility gives no chance for mucosal repair and NNAC plays a role; as discussed in literatures; by increasing such motility; In our study there was a remarkable reduction of levels of mucosal NNAC and hence colonic motility; determined by number of bouts, after induction of treatment leaving the field open to trials on the use of neuro-chemical transmitters blockers in an attempt to decrease, a rather monitored, rapid intestinal motility in order to help antibiotics overcome colonizing bacteria, also giving the chance to mucus membrane to recover. Conclusion: Fusobacterium varium colonsing colonic mucosa is one of the most important anaerobic pathogens that contribute to developing UC. Also, understanding the roles of IL-13, NK-CD57 and NNAC in UC should open more doors in developing new drugs like cytokine or cytokine receptor blockers or motility modification drugs in order to combat such a debilitating tumourgenic disease.

Article Details

Role of Interleukin-13 ( IL 13 ) , Natural Killer ( NK-CD57 ) Cells and Non Neural Acetyl Choline ( NNAC ) in Patients with Fusobacterium Varium Colonized Ulcerative Colitis in Specialized Medical Hospital ( SMH )

Authors:

Ibrahim Elmorsy | ElWakeel , G. A. | Monir Bahgat

Publisher:

The Egyptian Society of Medical Microbiology

Main Topics:

Medicine

Journal:

The Egyptian Journal of Medical Microbiology 2012 Vol.21 Issue 3, pp.125-136

Document Type:

Article

Publication Date:

7/2012

Document Language:

English

Document ID (Org No.):

49053

Frequency:

Quarterly

pISSN:

11102179

DOI:

10.12816/0004900

Descriptors:

COLITIS

CLOSTRIDIUM

FUSOBACTERIUM

MUCOSA

THERAPY

SERA

ANAEROBIC BACTERIA

MICROBIOLOGY

EGYPT

Issues

Article Details

Authors: Ibrahim Elmorsy | ElWakeel , G. A. | Monir Bahgat

Publisher: The Egyptian Society of Medical Microbiology

Main Topics: Medicine

Journal: The Egyptian Journal of Medical Microbiology 2012 Vol.21 Issue 3, pp.125-136

Document Type: Article

Publication Date: 7/2012

Document Language: English

Document ID (Org No.): 49053

Frequency: Quarterly

pISSN: 11102179

DOI: 10.12816/0004900

Descriptors:

Issues

Authors:

Ibrahim Elmorsy | ElWakeel , G. A. | Monir Bahgat

Publisher:

The Egyptian Society of Medical Microbiology

Main Topics:

Medicine

Journal:

The Egyptian Journal of Medical Microbiology 2012 Vol.21 Issue 3, pp.125-136

Document Type:

Article

Publication Date:

7/2012

Document Language:

English

Document ID (Org No.):

49053

Frequency:

Quarterly

pISSN:

11102179

DOI:

10.12816/0004900