Interleukin-2 concentration and C-reactive protein positivity among patients with irritable bowel syndrome in Diyala Province-Iraq
Keywords:
Irritable Bowel Syndrome, Interleukin-2, ELISA, CRPAbstract
Objectives: To assess the levels of C-reactive protein (CRP) and interleukin-2 (IL-2) concentration in patients clinically diagnosed with irritable bowel syndrome (IBS), and to compare these levels with those in a control group.
Methods: Seventy patients with IBS were diagnosed based on ultrasonography and clinical findings, and an additional 30 seemingly healthy individuals were included in the current study. The study was performed at Baqubah Teaching Hospital, Diyala, Iraq, over one year, from September 2019 to October 2020. IL-2 concentration was determined by enzyme-linked immunosorbent assay (Sino Gene Clon Biotech Co., Ltd., China), and CRP was standardized using particle-enhanced immunoturbidometric latex (Spinreact, Spain).
Results: The results showed a relationship between IL-2 concentration and socio-demographic factors. In IBS patients, the IL-2 concentration was highest in the 30-39 age group, though the variation was not statistically significant. For the control group, significant variation was observed (P = 0.013). IL-2 levels were slightly higher in IBS females compared to males, with no significant effect in controls. The C-reactive protein positivity rate (? 6 mg/dl) was significantly higher in IBS patients than in healthy controls (P = 0.048). IL-2 concentration was insignificantly higher in IBS patients compared to controls (P = 0.126).
Conclusions: The study suggests that alterations in CRP positivity and IL-2 concentration in patients with IBS may play a major role in its pathogenesis.
Downloads
References
Arenas-Ramirez N, Woytschak J. Interleukin-2: Biology, design, and application. Trends Immunol. 2015;36:763–77.
Liao W, Lin JX, Leonard WJ. IL-2 family cytokines: New insights into the complex roles of IL-2 as a broad regulator of T helper cell differentiation. Curr Opin Immunol. 2011;23(5):598–604. doi:10.1016/j.coi.2011.08.003.
Liao W, Lin JX, Leonard WJ. IL-2 family cytokines: New insights into the complex roles of IL-2 as a broad regulator of T helper cell differentiation. Curr Opin Immunol. 2011;23(5):598–604. doi:10.1016/j.coi.2011.08.003.
Boyman O, Sprent J. The role of interleukin-2 during homeostasis and activation of the immune system. Nat Rev Immunol. 2012;12(3):180–90. doi:10.1038/nri3156.
Farup PG, Ueland T, Rudi K, Lydersen S, Hestad K. Functional bowel disorders are associated with a central immune activation. Gastroenterol Res Pract. 2017;2017(27):1-9. doi:10.1155/2017/1642912.
Frandemark A, Jakobsson Ung E, Tornblom H, Simren M, Jakobsson S. Fatigue: a distressing symptom for patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017;29(1):1-9.
Agarwal N, Spiegel BM. The effect of irritable bowel syndrome on health-related quality of life and health care expenditures. Gastroenterol Clin North Am. 2011;40:11–9.
Gulewitsch MD, Enck P, Hautzinger M, Schlarb AA. Irritable bowel syndrome symptoms among German students: prevalence, characteristics, and associations to somatic complaints, sleep, quality of life, and childhood abdominal pain. Eur J Gastroenterol Hepatol. 2011;23:311–6.
Coss-Adame E, Rao SSC. Brain and gut interactions in irritable bowel syndrome: new paradigms and new understandings. Curr Gastroenterol Rep. 2014;16(4):379-89.
Thabane M, Marshall JK. Post-infectious irritable bowel syndrome. World J Gastroenterol. 2009;15(29):3591–6. doi:10.3748/wjg.15.3591.
Gonsalkorale WM, Perrey C, Pravica V, Whorwell PJ, Hutchinson IV. Interleukin 10 genotypes in irritable bowel syndrome: evidence for an inflammatory component? Gut. 2003;52(1):91–3.
Black S, Kushner I, Samols D. C-reactive protein. J Biol Chem. 2004;279(47):48487–90. doi:10.1074/jbc.R400025200.
Henderson P, Kennedy NA, Van Limbergen JE, Cameron FL, Satsangi J, Russell RK, Wilson DC. Serum C-reactive protein and CRP genotype in pediatric inflammatory bowel disease: influence on phenotype, natural history, and response to therapy. Inflamm Bowel Dis. 2015;21(3):596–605. doi:10.1097/MIB.0000000000000296.
Fu Y, Wu Y, Liu E. C-reactive protein and cardiovascular disease: From animal studies to the clinic (review). Exp Ther Med. 2020;20(2):1211–9. doi:10.3892/etm.2020.8840.
Chenillot O, Henny J, Steinmetz J, Herbeth B, Wagner C, Siest G. High sensitivity C-reactive protein: Biological variations and reference limits. Clin Chem Lab Med. 2000;38:1003–11.
Schoepfer AM, Beglinger C, Straumann A, Trummler M, Renzulli P, Seibold F. Ulcerative colitis: correlation of the Rachmilewitz Endoscopic Activity Index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009;15(12):1851–8. doi:10.1002/ibd.20986.
Mak WY, Buisson A, Rubin DT. Fecal calprotectin in assessing endoscopic and histological remission in patients with ulcerative colitis. Dig Dis Sci. 2018;63(5):1294–301.
Al-Damarchi AT, Al-Talakani GA. Association of Helicobacter pylori and irritable bowel syndrome. Indian J Public Health Res Dev. 2018;9:486–91.
Odhar HA, Hashim AF, Obaid DH, Majeed RS, Habeeb OA, Abdalhadi NM. Exploration of potential link between prevalence of irritable bowel syndrome and seropositivity for Helicobacter pylori. Indian J Public Health Res Dev. 2019;10(10):2236–40. doi:10.5958/0976-5506.2019.03187.5.
Cremon C, Gargano L, Morselli-Labate AM, Santini D, Cogliandro RF, De Giorgio R, Stanghellini V, Corinaldesi R, Barbara G. Mucosal immune activation in irritable bowel syndrome: gender-dependence and association with digestive symptoms. Am J Gastroenterol. 2009;104(2):392–400. doi:10.1038/ajg.2008.94.
Choghakhori R, Abbasnezhad A, Amani R, Alipour M. Sex-related differences in clinical symptoms, quality of life, and biochemical factors in irritable bowel syndrome. Dig Dis Sci. 2017;62:1550–60.
Houghton LA, Heitkemper M, Crowell M, et al. Age, gender, and women’s health and the patient. Gastroenterology. 2016;150:1332–43.
Meleine M, Matricon J. Gender-related differences in irritable bowel syndrome: potential mechanisms of sex hormones. World J Gastroenterol. 2014;20(22):6725–43. doi:10.3748/wjg.v20.i22.6725.
Hod K, Ringel-Kulka T, Martin CF, Ringel Y, Faculty S, Aviv T, Carolina N, Health C, Hill C, Carolina N, Diseases L, Aviv T, Aviv T. High levels of fecal calprotectin in irritable bowel syndrome. Mayo Clin Proc. 2017;50(3):227–32. doi:10.1097/MCG.0000000000000327.
Chen Y, Wang L, Feng S, Cai W, Chen X, Huang Z. The relationship between C-reactive protein/albumin ratio and disease activity in patients with inflammatory bowel disease. Gastroenterol Res Pract. 2020.
Barbara G, De Giorgio R, Stanghellini V, Cremon C, Salvioli B, Corinaldesi R. New pathophysiological mechanisms in irritable bowel syndrome. Aliment Pharmacol Ther. 2004;20(Suppl. 2):1–9. doi:10.1111/j.1365-2036.2004.02036.x.
Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012;367(17):1626–35. doi:10.1056/nejmra1207068.
Liebregts T, Adam B, Bredack C, Röth A, Heinzel S, Lester S, Downie-Doyle S, Smith E, Drew P, Talley NJ, Holtmann G. Immune activation in patients with irritable bowel syndrome. Gastroenterology. 2007;132(3):913–20. doi:10.1053/j.gastro.2007.01.04.
Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004;292:852–8.
Menees SB, Powell C, Kurlander J, Goel A, Chey WD. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015;110:444–54.
Suk Danik J, Chasman DI, Cannon CP, Miller DT, Zee RY, Kozlowski P, Kwiatkowski DJ, Ridker PM. Influence of genetic variation in the C-reactive protein gene on the inflammatory response during and after acute coronary ischemia. Ann Hum Genet. 2006;70:705–16.
Henderson P, Kennedy NA, Van Limbergen JE, Cameron FL, Satsangi J, Russell RK, Wilson DC. Serum C-reactive protein and CRP genotype in pediatric inflammatory bowel disease: influence on phenotype, natural history, and response to therapy. Inflamm Bowel Dis. 2015;21(3):596–605. doi:10.1097/MIB.0000000000000296.
Patel S, Singh A, Misra V, Misra SP, Dwivedi M, Trivedi P. Levels of interleukins 2, 6, 8, and 10 in patients with irritable bowel syndrome. Indian J Pathol Microbiol. 2017;60(3):385–9. doi:10.4103/IJPM.IJPM_544_16.
West GA, Fiocchi C, Ferraris L, Klein S. Receptors in inflammatory bowel disease. 2006–2014.
Vara EJ, Brokstad KA, Hausken T, Lied GA. Altered levels of cytokines in patients with irritable bowel syndrome are not correlated with fatigue. Int J Gen Med. 2018;11:285–91. doi:10.2147/IJGM.S166600.
Chadwick VS, Chen W, Shu D, Paulus B, Bethwaite P, Tie A, Wilson I. Activation of the mucosal immune system in irritable bowel syndrome. Gastroenterology. 2002;122(7):1778–83. doi:10.1053/gast.2002.33579.
Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004;292:852–8.
Marshall JK, Thabane M, Garg AX, Clark W, Meddings J, Collins SM. Intestinal permeability in patients with irritable bowel syndrome after a waterborne outbreak of acute gastroenteritis in Walkerton, Ontario. Aliment Pharmacol Ther. 2004;20:1317–22.
Spiller R, Campbell E. Post-infectious irritable bowel syndrome. Curr Opin Gastroenterol. 2006;22:13–7.
Grover M, Herfarth H, Drossman DA. The functional-organic dichotomy: postinfectious irritable bowel syndrome and inflammatory bowel disease-irritable bowel syndrome. Clin Gastroenterol Hepatol. 2009;7(1):48–53. doi:10.1016/j.cgh.2008.08.032.
Ohman L, Isaksson S, Lindmark AC, Posserud I, Stotzer PO, Strid H, Sjövall H, Simrén M. T-cell activation in patients with irritable bowel syndrome. Am J Gastroenterol. 2009;104(5):1205–12. doi:10.1038/ajg.2009.116.
O’Mahony L, McCarthy J, Kelly P, Hurley G, Luo F, Chen K, O’Sullivan GC, Kiely B, Collins JK, Shanahan F, Quigley EMM. Lactobacillus and Bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology. 2005;128(3):541–51. doi:10.1053/j.gastro.2004.11.0
Downloads
Published
How to Cite
Issue
Section
License
Copyright and Licensing
For all articles published in Atena Journals, copyright is retained by the authors. Articles are licensed under an open access Creative Commons CC BY 4.0 license, meaning that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. These conditions allow for maximum use and exposure of the work, while ensuring that the authors receive proper credit.
Reproducing Published Material from other Publishers
It is absolutely essential that authors obtain permission to reproduce any published material (figures, schemes, tables or any extract of a text) which does not fall into the public domain, or for which they do not hold the copyright. Permission should be requested by the authors from the copyrightholder (usually the Publisher, please refer to the imprint of the individual publications to identify the copyrightholder).
Permission is required for:
- Your own works published by other Publishers and for which you did not retain copyright.
- Substantial extracts from anyones' works or a series of works.
- Use of Tables, Graphs, Charts, Schemes and Artworks if they are unaltered or slightly modified.
- Photographs for which you do not hold copyright.
Permission is not required for:
- Reconstruction of your own table with data already published elsewhere. Please notice that in this case you must cite the source of the data in the form of either "Data from..." or "Adapted from...".
- Reasonably short quotes are considered fair use and therefore do not require permission.
- Graphs, Charts, Schemes and Artworks that are completely redrawn by the authors and significantly changed beyond recognition do not require permission.
Obtaining Permission
In order to avoid unnecessary delays in the publication process, you should start obtaining permissions as early as possible. If in any doubt about the copyright, apply for permission. Atena Journals cannot publish material from other publications without permission.
The copyright holder may give you instructions on the form of acknowledgement to be followed; otherwise follow the style: "Reproduced with permission from [author], [book/journal title]; published by [publisher], [year].' at the end of the caption of the Table, Figure or Scheme.
