Cargando…

Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease

INTRODUCTION: Clinical trials are currently investigating whether an extended mesenteric resection for ileocecal resections could reduce postoperative recurrence in Crohn's disease. Resection of the mesorectum, which contains proinflammatory macrophages, during proct(ocol)ectomy, is associated...

Descripción completa

Detalles Bibliográficos
Autores principales: van der Meer, Jonathan H.M., Wasmann, Karin A.T.G.M., van der Bilt, Jarmila D.W., Becker, Marte A.J., Boermeester, Marja A., Bemelman, Willem A., Wildenberg, Manon E., Buskens, Christianne J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641506/
https://www.ncbi.nlm.nih.gov/pubmed/32739925
http://dx.doi.org/10.14309/ctg.0000000000000198
_version_ 1783605930934403072
author van der Meer, Jonathan H.M.
Wasmann, Karin A.T.G.M.
van der Bilt, Jarmila D.W.
Becker, Marte A.J.
Boermeester, Marja A.
Bemelman, Willem A.
Wildenberg, Manon E.
Buskens, Christianne J.
author_facet van der Meer, Jonathan H.M.
Wasmann, Karin A.T.G.M.
van der Bilt, Jarmila D.W.
Becker, Marte A.J.
Boermeester, Marja A.
Bemelman, Willem A.
Wildenberg, Manon E.
Buskens, Christianne J.
author_sort van der Meer, Jonathan H.M.
collection PubMed
description INTRODUCTION: Clinical trials are currently investigating whether an extended mesenteric resection for ileocecal resections could reduce postoperative recurrence in Crohn's disease. Resection of the mesorectum, which contains proinflammatory macrophages, during proct(ocol)ectomy, is associated with reduced recurrent inflammation and improved wound healing. We aimed to characterize the macrophages in the ileocecal mesentery, which were compared with those in the mesorectum, to provide a biological rationale for the ongoing trials. METHODS: In 13 patients with Crohn's disease and 4 control patients undergoing a proctectomy, tissue specimens were sampled at 3 locations from the mesorectum: distal (rectum), middle, and proximal (sigmoid). In 38 patients with Crohn's disease and 7 control patients undergoing ileocecal resections, tissue specimens also obtained from 3 locations: adjacent to the inflamed terminal ileum, adjacent to the noninflamed ileal resection margin, and centrally along the ileocolic artery. Immune cells from these tissue specimens were analyzed by flow cytometry for expression of CD206 to determine their inflammatory status. RESULTS: In the mesorectum, a gradient from proinflammatory to regulatory macrophages from distal to proximal was observed, corresponding to the adjacent inflammation of the intestine. By contrast, the ileocecal mesentery did not contain high amounts of proinflammatory macrophages adjacent to the inflamed tissue, and a gradient toward a more proinflammatory phenotype was seen in the central mesenteric area. DISCUSSION: Although the mesentery is a continuous structure, the mesorectum and the ileocecal mesentery show different immunological characteristics. Therefore, currently, there is no basis to perform an extended ileocecal resection in patients with Crohn's disease.
format Online
Article
Text
id pubmed-7641506
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer
record_format MEDLINE/PubMed
spelling pubmed-76415062020-11-05 Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease van der Meer, Jonathan H.M. Wasmann, Karin A.T.G.M. van der Bilt, Jarmila D.W. Becker, Marte A.J. Boermeester, Marja A. Bemelman, Willem A. Wildenberg, Manon E. Buskens, Christianne J. Clin Transl Gastroenterol Article INTRODUCTION: Clinical trials are currently investigating whether an extended mesenteric resection for ileocecal resections could reduce postoperative recurrence in Crohn's disease. Resection of the mesorectum, which contains proinflammatory macrophages, during proct(ocol)ectomy, is associated with reduced recurrent inflammation and improved wound healing. We aimed to characterize the macrophages in the ileocecal mesentery, which were compared with those in the mesorectum, to provide a biological rationale for the ongoing trials. METHODS: In 13 patients with Crohn's disease and 4 control patients undergoing a proctectomy, tissue specimens were sampled at 3 locations from the mesorectum: distal (rectum), middle, and proximal (sigmoid). In 38 patients with Crohn's disease and 7 control patients undergoing ileocecal resections, tissue specimens also obtained from 3 locations: adjacent to the inflamed terminal ileum, adjacent to the noninflamed ileal resection margin, and centrally along the ileocolic artery. Immune cells from these tissue specimens were analyzed by flow cytometry for expression of CD206 to determine their inflammatory status. RESULTS: In the mesorectum, a gradient from proinflammatory to regulatory macrophages from distal to proximal was observed, corresponding to the adjacent inflammation of the intestine. By contrast, the ileocecal mesentery did not contain high amounts of proinflammatory macrophages adjacent to the inflamed tissue, and a gradient toward a more proinflammatory phenotype was seen in the central mesenteric area. DISCUSSION: Although the mesentery is a continuous structure, the mesorectum and the ileocecal mesentery show different immunological characteristics. Therefore, currently, there is no basis to perform an extended ileocecal resection in patients with Crohn's disease. Wolters Kluwer 2020-08-03 /pmc/articles/PMC7641506/ /pubmed/32739925 http://dx.doi.org/10.14309/ctg.0000000000000198 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
van der Meer, Jonathan H.M.
Wasmann, Karin A.T.G.M.
van der Bilt, Jarmila D.W.
Becker, Marte A.J.
Boermeester, Marja A.
Bemelman, Willem A.
Wildenberg, Manon E.
Buskens, Christianne J.
Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title_full Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title_fullStr Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title_full_unstemmed Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title_short Anatomical Variation in Mesenteric Macrophage Phenotypes in Crohn's Disease
title_sort anatomical variation in mesenteric macrophage phenotypes in crohn's disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641506/
https://www.ncbi.nlm.nih.gov/pubmed/32739925
http://dx.doi.org/10.14309/ctg.0000000000000198
work_keys_str_mv AT vandermeerjonathanhm anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT wasmannkarinatgm anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT vanderbiltjarmiladw anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT beckermarteaj anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT boermeestermarjaa anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT bemelmanwillema anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT wildenbergmanone anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease
AT buskenschristiannej anatomicalvariationinmesentericmacrophagephenotypesincrohnsdisease