Ileal pouch-anal anastomosis has become the most widely accepted procedure for surgical treatment of patients with ulcerative colitis.
The primary function of the ileum within the pouch changes from absorption to storage.
Malignancies have been described in the pouch mucosa.
The detoxifying glutathione S-transferase enzymes are involved in the mucosal protection against toxins and carcinogens.
Levels of glutathione S-transferases are much higher in the ileum as compared with the colon.
The adaptation of the ileal pouch mucosa into a more colon-like phenotype possibly influences the activity and levels of glutathione S-transferase.
Dr Fokko Nagengast and colleagues assessed the detoxification capacity of glutathione S-transferase of the afferent ileal limb mucosa.
The research team compared this with the ileal pouch mucosa of patients with ulcerative colitis.
|Glutathione S-transferase P1 levels were higher in the pouch|
|Inflammatory Bowel Diseases|
The team obtained biopsies from normal-appearing mucosa from the ileal pouch and the ileal afferent limb from 18 patients with ulcerative colitis.
Glutathione S-transferase isoforms were quantified by immunoblotting.
The team spectrophotometrically measured glutathione S-transferase activity.
Glutathione and cysteine levels were determined by high-performance liquid chromatography.
The researchers found that the glutathione S-transferase activity and glutathione S-transferase A1+A2 levels were lower in the pouch vs the afferent ileal limb in ulcerative colitis.
However, the team noted that the glutathione S-transferase P1 levels were higher in the pouch.
No differences were observed in the levels of glutathione S-transferase M1, glutathione S-transferase T1, glutathione, or cysteine.
Dr Nagengast's team concluded, “The lower glutathione S-transferase detoxification activity in the pouch mucosa of patients with ulcerative colitis may result in higher levels of toxins and carcinogens.”
“This partly contributes to the risk of developing malignancies in the pouch.”