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The following is a summary of “Importance of rectal over colon status in ulcerative colitis remission: the role of microinflammation and mucosal barrier dysfunction in relapse,” published in the December 2024 issue of Gastroenterology by Nishioka et al.
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) affecting the rectum and colon, with the rectal environment playing a key role in initiating relapse in individuals with UC.
Researchers conducted a prospective study to examine gene expression differences between the rectum and colon and identify relapse factors in individuals with UC.
They performed RNA sequencing on biopsies from the colon and rectum of individuals with active UC, remission UC, and control participants. Mucosal impedance (MI), tight junction protein mRNA expression, and inflammatory cytokines (interleukin [IL]-1β, IL-6) were examined in 32 individuals with remission UC and 22 controls.
The results showed that RNA sequencing identified distinct gene profiles in the rectum and sigmoid colon of individuals with remission UC. The rectum exhibited an enriched immune response and persistent claudin 2 (CLDN2) gene expression upregulation. Additionally, MI was significantly lower in the rectum (P<0.05) and negatively correlated with CLDN2, IL-1β, and IL-6 expression.
They concluded that the rectum in individuals with remission UC showed microinflammation and impaired mucosal barrier function, contributing to relapse, with CLDN2 upregulation playing a role.
Source: link.springer.com/article/10.1007/s00535-024-02199-4
