Musosal tumour necrosis factor α in diverticular disease of the colon is overexpressed with disease severity.

Abstract Aim Inflammation occurs in diverticular disease (DD),but there is little information on inflammatory cytokinessuch as tumour necrosis factor a (TNF-a). The aim of thisstudy was to assess TNF-a expression in DD and to seewhether it is related to the severity of the disease.Method Twenty-four patients with symptomatic DDwere divided into those with acute uncomplicated diver-ticulitis (AUD) (12 patients) and those with symptomaticuncomplicated diverticular disease (SUDD) (12 patients).Twelve further patients with asymptomatic diverticulosis(AD), six with segmental colitis associated with divertic-ulosis(SCAD),withulcerativecolitis(UC)andsixhealthyindividuals (HC) were enrolled as controls. TNF-aexpression in the colonic mucosa was assessed by theamount of mRNA codifying for the synthesis of TNF-a.Results TNF-a expression was significantly higher inAUD than in HC (P = 0.0007), in AD (P = 0.0001) andin SUDD (P = 0.0179). It was significantly higher also inSUDD than in HC (P = 0.0007) and in AD(P = 0.0001). TNF-a expression in AUD did not differsignificantly from that in UC (P = 0.0678) and SCAD(P = 0.0610). It was significantly higher in UC, SCADand AUD than in SUDD (P = 0.0007, P = 0.0001,P = 0.0179).Conclusion TNF-a expression in DD seems to be relatedto the severity of the disease. In particular, it appears tobe overexpressed in DD with inflammation (AUD andSUDD) compared with DD without (AD).Keywords Diverticular disease, diverticulitis, segmentalcolitis associated with diverticulosis, tumour necrosisfactor aWhat is new in this paper?The paper reports for the first time that tumour necrosisfactor a expression may be increased in diverticulardisease. The results indicate that tumour necrosis factora expression is related to the severity of disease.