TGF-β1 and IGF-1 Production and Recurrence of Crohn's Disease After Ileo-Colonic Resection

Background

Recurrence after surgery is a major problem in the treatment of Crohn's disease (CD). Alteration of healing processes may play a role in this phenomenon. Transforming growth factor beta (TGF-β) and insulin-like growth factor (IGF-1) have pro-fibrogenic properties and are involved in wound-healing mechanisms. The aim of this study was to assess their role in the CD recurrence after ileo-colonic resection.

Patients and methods

Twenty patients with CD, who underwent ileo-colonic resection in the period between 1999 and 2005, were enrolled in this study. Tissue samples were obtained from macroscopically diseased and healthy ileum. The TGF-β1 and IGF-1 mRNAs were quantified by real-time polymerase chain reaction using glyceraldehyde 3-phosphate dehydrogenase as the housekeeping gene. Histological severity of the disease was assessed to quantify the ileal inflammation. Patients' follow-up was investigated. Comparisons and correlations were carried out with nonparametric tests and survival analysis was performed.

Results

Histological inflammation was moderately severe in the diseased bowel, while it was absent in healthy segments (P < 0.01). TGF-β1 production in healthy bowels showed a direct correlation with clinical CD recurrence (τ = 0.43, P = 0.04) and survival analysis showed that patients who expressed high TGF-β1 mRNA transcripts in healthy intestines had higher cumulative recurrence rates than those who expressed low TGF-β1 mRNA levels (P = 0.02).

Conclusion

Our study suggests that the high levels of TGF-β1 in healthy bowels of patients who undergo ileo-colonic resection for CD are associated with early clinical disease recurrence, while there seems to be no association between IGF-1 and CD recurrence.

Key Words: Crohn's disease, recurrence, TGF-β1, IGF-1, myeloperoxidase