Introduction: As a T cell-mediated disease of the gastrointestinal epithelium, Crohn's disease (CD) is likely to share pathogenic elements with other T cell-mediated inflammatory diseases. Recently we showed that ulcerative colitis (UC) manifested large-scale molecular disturbances that correlated with endoscopic and histologic features(IBD 20: 2353, 2014). We hypothesized that ileal CD would manifest similar disturbance. Methods: We studied 27 patients in 31 biopsies with ileal CD, characterizing the clinical, endoscopic and histological features and defined the mRNA phenotype using microarray analysis of ileal biopsies. We measured the expression of pathogenesis-based transcript sets (PBTs) previously published for ulcerative colitis representing effector T cells, macrophages, IFNG effects, and parenchymal injury-repair response and dedifferentiation (table 1). The molecular features were then correlated with conventional assessments including clinical features (modified Harvey Bradshaw index(HBI), simple endoscopic score for CD(SES-CD), c-reactive protein, albumin) and histologic features (lamina propria neutrophilic and lymphoplasmacytic infiltrate, crypt abscess, ulcers present and crypt architectural distortion). Results: CD ileal biopsies arranged by injury-repair score (IRRAT) manifested coordinate transcript changes with IFNG-induced transcripts (GRIT), macrophage transcripts (QCMAT), and injury-repair transcripts increasing while parenchymal transcripts (PT) decreased (figure 1). Lymphoplasmacytic infiltrate was significantly correlated with IRRAT (P=0.005) and negatively correlated with parenchymal transcript expression (P=0.01). Neutrophilic lamina propria infiltrate (p=0.03) and number of ulcers (p=0.03) also correlated with IRRAT. No significant correlation was seen between the molecular features and the HBI (P=0.5), SES-CD(P=0.8) or CRP (0.2).Figure 1Table 1: Pathogenesis-based transcript sets (PBTs)Conclusion: The molecular phenotype of CD manifests a large-scale coordinate disturbance similar to that in UC and other T cell-mediated diseases, reflecting changes in inflammatory cells and parenchymal elements and correlating with histologic assessment, especially the lymphoplasmacytic and neutrophilic lamina propria infiltrate, but not with the clinical and endoscopic features. This raises further questions about our clinical and endoscopic assessments of CD. Novel molecular systems for quantitating and staging the disease elements in the tissues in CD may add a significant new dimension to patient management beyond our current standards.
Abstract Systemic Lupus Erythematosus (SLE) is a chronic, multisystem, autoimmune disorder with a broad range of clinical presentations. One of the main factors, proposed to contribute to the development of clinical manifestations of SLE is accumulation and impaired clearance of immune complexes. The aim of the present study was to investigate lipid and anti-lipid antibody profiles in SLE patients’ plasma using ELISA and gas chromatography-mass spectrometry (GC-MS). The SLE cohort employed in this study is composed of 24 subjects and disease monitoring was undertaken with serial BILAG disease scoring. The blood was collected at three time points: at the moment of flare; and 3-months/12-months after treatment had started. For oxysterols (7α-hydroxycholesterol, 7β-hydroxycholesterol, 7-ketocholesterol) we report a trend where lipid levels and corresponding anti-lipid IgG concentrations are significantly reduced during the course of treatment. For phospholipids (oxidized phosphatidylcholine, cardiolipin) we also show high levels of anti-lipid IgG during flare or active disease. Using GC-MS and ELISA we have confirmed an association of high lipid levels and high anti-lipid IgG level with disease flare in comparison to 12 months after the commencement of treatment. We propose that auto anti-lipid IgGs should now be considered a component of the accumulated immune complexes in SLE and thus may contribute to disease pathogenesis.