BACKGROUND: Lean body mass wastage in active Crohn's disease is not only related to malnutrition, but also to local and systemic inflammation. Altered bowel permeability can represent a source of pro-inflammatory cytokines, that have been shown to produce muscle wastage by several mechanisms such as apoptosis. In our study we have evaluated the body composition and the pathological changes of skeletal muscle in patients with Crohn's disease to see whether a relationships between altered gut permeability, proinflammatory cytokines production and muscle wastage existed. METHODS: Thirteen consecutive steroid-free patients with active Crohn's disease underwent evaluation of body composition, sugar test for intestinal permeability, determination of serum levels of TNF-alpha, sphingosine, bacterial lipopolysaccaride, and biopsy of gastrocnemius. In bioptic samples we determined fibres cross sectional area, distribution of myosin heavy chains and apoptosis. Twenty healthy subjects formed the control group. RESULTS: In patients lean body mass was reduced and intestinal permeability increased (p<0.01 for both). TNFalpha, sphingosine and lipopolysaccaride were increased (p<0.01). Fibres size was reduced (p<0.01), with shift of Myosin Heavy Chains from the slow to the fast type. Apoptosis was found in 5 patients' biopsies, never in controls. CONCLUSIONS: Crohn's patients have a myopathy characterized by myocyte apoptosis, modifications of myosin and muscle atrophy. TNF-alpha and sphingosine, that are increased because of the enhanced lipopolysaccaride concentration due to altered gut permeability, may play a pathophysiological role in the development of this myopathy.
BACKGROUND: Lean body mass wastage in active Crohn's disease is not only related to malnutrition, but also to local and systemic inflammation. Altered bowel permeability can represent a source of pro-inflammatory cytokines, that have been shown to produce muscle wastage by several mechanisms such as apoptosis. In our study we have evaluated the body composition and the pathological changes of skeletal muscle in patients with Crohn's disease to see whether a relationships between altered gut permeability, proinflammatory cytokines production and muscle wastage existed. METHODS: Thirteen consecutive steroid-free patients with active Crohn's disease underwent evaluation of body composition, sugar test for intestinal permeability, determination of serum levels of TNF-alpha, sphingosine, bacterial lipopolysaccaride, and biopsy of gastrocnemius. In bioptic samples we determined fibres cross sectional area, distribution of myosin heavy chains and apoptosis. Twenty healthy subjects formed the control group. RESULTS: In patients lean body mass was reduced and intestinal permeability increased (p<0.01 for both). TNFalpha, sphingosine and lipopolysaccaride were increased (p<0.01). Fibres size was reduced (p<0.01), with shift of Myosin Heavy Chains from the slow to the fast type. Apoptosis was found in 5 patients' biopsies, never in controls. CONCLUSIONS: Crohn's patients have a myopathy characterized by myocyte apoptosis, modifications of myosin and muscle atrophy. TNF-alpha and sphingosine, that are increased because of the enhanced lipopolysaccaride concentration due to altered gut permeability, may play a pathophysiological role in the development of this myopathy.
Authors: Nik Sheng Ding; Daniel Tassone; Ibrahim Al Bakir; Kyle Wu; Alexander J Thompson; William R Connell; George Malietzis; Phillip Lung; Siddharth Singh; Chang-Ho Ryan Choi; Simon Gabe; John T Jenkins; Ailsa Hart Journal: J Crohns Colitis Date: 2022-09-08 Impact factor: 10.020
Authors: Jan Bilski; Agnieszka Mazur-Bialy; Dagmara Wojcik; Marcin Surmiak; Marcin Magierowski; Zbigniew Sliwowski; Robert Pajdo; Slawomir Kwiecien; Aleksandra Danielak; Agata Ptak-Belowska; Thomas Brzozowski Journal: Biomolecules Date: 2019-11-26
Authors: Jie Dong; Yi Chen; Yuchen Tang; Fei Xu; Chaohui Yu; Youming Li; Prasoon Pankaj; Ning Dai Journal: PLoS One Date: 2015-12-14 Impact factor: 3.240
Authors: Sandra J van Krimpen; Fleur A C Jansen; Veerle L Ottenheim; Clara Belzer; Miranda van der Ende; Klaske van Norren Journal: Nutrients Date: 2021-03-29 Impact factor: 5.717