Tohoku J. Exp. Med., 2021 July, 254(3)

Increased Severity of Ulcerative Colitis in the Terminal Phase of the Metabolic Syndrome

Marina Milun Jovanovic,1 Milena Milenko Jurisevic,2 Nevena Miroslav Gajovic,3 Nebojsa Nikola Arsenijevic,3 Miodrag Vukasin Jocic,4 Ivan Petar Jovanovic,3 Natasa Dragan Zdravkovic,1 Aleksandar Ljubodrag Djukic,5 Veljko Jovo Maric6 and Milan Milorad Jovanovic7

1Department of Internal medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
2Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
3Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
4Institute for Transfusiology and Haemobiology, Military Medical Academy, Belgrade, Serbia
5Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
6Department of Surgery, Faculty of Medicine Foca, University of East Sarajevo, Sarajevo, Bosnia and Herzegovina
7Department of Abdominal surgery, Military Medical Academy, Belgrade, Serbia

Ulcerative colitis is chronic immune-mediated disorder that affects primarily colonic mucosa. The metabolic syndrome has increasing global prevalence with a significant impact on biology of chronic diseases, such as ulcerative colitis. Today it is known that the metabolic syndrome attenuates severity of ulcerative colitis. Still, there is no evidence that different stages of metabolic syndrome alter the course of the ulcerative colitis. The aim of this study was to dissect out how progression of the metabolic syndrome impacted the biology of ulcerative colitis and severity of clinical presentation. Seventy-two patients (41 men and 31 women, 22-81 years old) were enrolled in this observational cross-sectional study. Concentrations of pro- and anti-inflammatory cytokines in serum and feces samples were measured and phenotype of colon infiltrating cells was analyzed. Patients in the terminal phase of the metabolic syndrome have clinically and pathohistologically more severe form of ulcerative colitis, which is followed by decreased concentrations of systemic galectin-1, increased values of systemic pro-inflammatory mediators and increased influx of lymphocytes in affected colon tissue. Our data suggest that reduced concentrations of galectin-1 and predomination of the pro-inflammatory mediators in patients with terminal stage of the metabolic syndrome enhance local chronic inflammatory response and subsequent tissue damage, and together point on important role of galectin-1 in immune response in ulcerative colitis patients with the metabolic syndrome.

Key words —— disease severity; immune response; metabolic syndrome progression; ulcerative colitis

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Tohoku J. Exp. Med 2021, 254, 171-182.

Correspondence: Nevena Gajovic, M.D., Ph.D., Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, Kragujevac 34000, Serbia.

e-mail: gajovicnevena@yahoo.com