The aim of this work was to measure peripheral lymphocyte apoptosis during IBD flare and remission. Subjects and Methods. Flow-cytometric assessment of apoptosis of peripheral blood lymphocytes (PBL) was assessed in 30 children with IBD (16 with ulcerative colitis and 14 with Crohn’s disease) compared to 22, age and sex matched, healthy children. This was carried out during a flare, whether in newly diagnosed or relapsing patients, and after achievement of remission. Clinical findings, complete blood count, liver transaminases, and kidney functions were assessed. Results. Early apoptotic and late apoptotic/necrotic lymphocytes were significantly higher during IBD flare compared to controls ( and <0.01, resp., in ulcerative colitis and and <0.01, resp., in Crohn’s disease patients). Remission values were significantly decreased but did not come back to the control levels. Early apoptotic values were significantly related to joint involvement in IBD patients ( ). Conclusions. We can speculate a systemic nature of IBD as evident by enhanced peripheral lymphocyte apoptosis. This is related, to a great extent, to the disease process as it is more deranged in flare than in remission. Relation of this derangement to extraintestinal manifestations needs a special attention. 1. Introduction Although the exact etiology of inflammatory bowel disease (IBD) still remains unclear, its pathophysiological mechanisms have been more extensively investigated. Nowadays, it is commonplace that in IBD, a wide diversity of immunological changes occurs, including altered populations of inflammatory cells and activation of a range of systemic inflammatory pathways [1–3]. Thus, Crohn’s disease (CD) and ulcerative colitis (UC) should both be considered as systemic diseases being associated with clinical manifestations involving different organs outside the alimentary tract [4–6]. Apoptosis is a well-recognized process of cell death occurring as a series of changes in dying cells under several physiological conditions. On the other hand, necrosis occurs with cell death and empties its contents into the surroundings [7]. With starting apoptosis, phosphatidyl residues are externalized. Annexin V preferentially binds to phosphatidyl residues that can be identified by flow-cytometry [8]. Several studies have also addressed the role of apoptosis of intestinal lymphocytes in IBD. The noninflamed gut T cells have an increased susceptibility towards apoptosis that places a limit on the expansion of T cells and downregulates the mucosal immune response following direct or bystander
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