ORIGINAL ARTICLE

Comparison of RANTES expression in Crohn’s disease and ulcerative colitis: an aid in the differential diagnosis?

N Ansari¹, J Abdulla¹, N Zayyani², U Brahmi¹, S Taha¹, A A Satir¹

¹ Department of Pathology, Arabian Gulf University, Bahrain
² Department of Internal Medicine, Bahrain Specialist Hospital, Juffair, Bahrain

Correspondence to:
N Ansari
Arabian Gulf University, PO Box 22979, Bahrain; ansarnas{at}hotmail.com

Background: RANTES (regulated on activation, normal T cell expressed and secreted) expression is increased in inflammatory bowel disease (IBD). RANTES is produced at higher levels in granulomatous conditions, so increased RANTES expression can be expected in Crohn’s disease compared with ulcerative colitis.

Aim: To compare RANTES expression between intestinal biopsy specimens of patients with Crohn’s disease and those with ulcerative colitis.

Materials and methods: A prospective study of patients presenting with lower gastrointestinal symptoms at the Bahrain Specialist Hospital from July 2004 to April 2005 was carried out. Endoscopic colonic biopsy specimens were taken from every patient and subjected to (a) routine haematoxylin and eosin staining examination by light microscopy, (b) immunohistochemistry for examination of RANTES protein expression by light microscopy and (c) in situ hybridisation for examination of RANTES mRNA expression by light microscopy. RANTES expression was assessed and quantified.

Results: 58 patients were enrolled to the study. Of them, 40 had IBD (21 had Crohn’s disease and 19 had ulcerative colitis), 15 were controls with normal colonic biopsy results or non-inflammatory lesions and 3 had colonic inflammatory lesions other than IBD. RANTES expression in lymphocytes or histiocytes was significantly higher (p = 0.04) in new patients with ulcerative colitis than in those with Crohn’s disease analysed by immunohistochemistry (IHC).

Conclusion: RANTES expression in lymphocytes or histiocytes is significantly higher in patients with ulcerative colitis than in those with Crohn’s disease. Hence, RANTES IHC can be an effective method for distinguishing between biopsy specimens of patients with ulcerative colitis from those of patients with Crohn’s disease, where routine histological features are indeterminate. RANTES IHC may prove to be a useful technique for identifying early or equivocal granulomas.

Abbreviations: BSH, Bahrain Specialist Hospital; IBD, inflammatory bowel disease; IHC, immunohistochemistry; ISH, in situ hybridisation; MCP, monocyte chemoattractant protein; RANTES, regulated on activation, normal T cell expressed and secreted

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Henckaerts, L., Fevery, J., Van Steenbergen, W., Verslype, C., Nevens, F., Yap, P., Roskams, T., Rutgeerts, P., Vermeire, S. (2007). The RANTES -28 g polymorphism is associated with primary sclerosing cholangitis. Gut 56: 891-892 [Full Text]  
• Chen, M. C., Keshavan, P., Gregory, G. D., Klumpp, D. J. (2007). RANTES mediates TNF-dependent lamina propria mast cell accumulation and barrier dysfunction in neurogenic cystitis. Am. J. Physiol. Renal Physiol. 292: F1372-F1379 [Abstract] [Full Text]