Clinical Studies On The Expression Of IL-4 And IL-6 In Intestinal Mucosa And Its Relation With Anxietydepression Of IBS-D Patients

Objectives By comparing the positive expression of IL-6, IL-4 in intestinal mucosa immunohistochemical between diarrhea-predominant irritable bowel syndrome and normal control group, and analysing the differences among different intestinal mucosal positions of the positive expression of IL-6, IL-4 in patients with IBS-D, and researching anxietydepression beween the case group and the control group, analysising further the relation of anxiety-depression and the positive expression of IL-6, IL-4 in patients with IBS-D.Providing valuable clues for the study of the pathogenesis of IBS.Methods 1 We chose 32 numbers of IBS-D patients as the case group who visited the North China University of Science and Technology gastroenterology clinic and inpatient department from January 2013 to June 2014. All of the patients conformed to the Rome Ⅲdiagnostic criteria. While 32 numbers of no gastrointestinal symptoms in healthy volunteers and examinations as the control group. 2 Before colonoscopy, all of the subjects need to sign the informed consent form of endoscopy. We biopsied 1 piece of intestinal mucosal tissue from terminal ileum, ileocecus and rectum-sigmoid junction under endoscope by disposable biopsy forceps as histological specimens. Making slice after fixative fixed, and staining all the specimens with HE to observe the intestinal mucosa. The positive expression of IL-6, IL-4 in intestinal mucosa were observed by immunohistochemical methods, and the strength of the expressions were measured by integral optical density. 3 Statisticaling the basic data of all subjects by the general questionnaire(homemade); and doing a survey by the Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD). 4 Finally, we established a database with SPSS17.0 software for statistical analysis, and all the data for statistical analysing and processing. Before the analysis, all the statistical data were performed by normality testing and homogeneity of variance testing. Measurement data was expressed by mean standard±deviation. Using t test(approximate t test) for comparison between two sample means, and one-way analysis of variance for comparison among more sample means;Using chi-square test for count data. We considered P﹤0.05 statistically significant, and P﹤0.01 statistically significant evidently.Results 1 The average IODs of IL-6 in three parts of intestinal mucosa in case group were higher than those in the control group(12.48±3.46vs10.51±2.54), the difference was statistically significant(P ﹤ 0.05); While the average IODs of IL-4 had no statistical difference compared with the control group(5.35±1.51vs5.53±1.86, P﹥0.05). 2 The IODs of IL-6 in the ileocecum of the cases group were higher than those in terminal ileum and rectum-sigmoid junction(14.42±4.65vs11.07±3.55vs11.93±3.42), and the difference was statistically significant(P﹤0.05); However, the IODs of IL-4 in the ileocecum of the cases group were higher than those in terminal ileum and rectum-sigmoid junction(6.30±2.74vs5.10±2.00vs4.79±2.70), but there was no statistical difference(P﹥0.05). 3 The scores of HAMA and HAMD in the case group were both higher than in the control group(10.00±4.95vs6.13±3.51),(10.31±3.54vs5.22±2.54), the differences were statistically significant evidently(P ﹤ 0.01). What was more, we found the scores of HAMA and HAMD in the case group of female patients were higher than male patients(11.05±5.38vs7.18±3.13),(11.24±3.58vs8.00±2.53), the difference was statistically significant(P ﹤ 0.05). 4 In the case group, IL-6 immunohistochemical expression inintestinal mucosa of patients with anxiety and depression had statistical difference than the ones without anxiety and depression(P ﹤ 0.05); However, IL-4 immunohistochemical expression had no statistical difference between them(P﹥0.05).5 In this study,we found that the IODs of IL-6 in the case group of female patients were higher than male patients(13.99±3.41vs10.59±2.77), the difference was statistically significant(P﹤0.05). Besides, the IODs of IL-4 in the case group of female patients were higher than male patients(5.51±1.39vs5.03±1.92), but there was no statistical difference(P﹥0.05).Conclusions 1 The expression of IL-6 is high in intestinal mucosa of IBS-D patients, and there is unbalance beween the expression of IL-6 and IL-4. 2 The IL-6 in the ileocecum is higher expressed especially among defferent parts of intestinal mucosa with IBS-D patients.3 There is gender difference in the expression of IL-6 with IBS-D patients possibly, female patients is higher expressed than male ones. 4 Most of IBS-D patients especially female are likely to have anxiety-depression state, which perhaps prompts there is gender difference in psychologic disturbance with IBS-D patients. 5 Anxiety-depression state and the expression of IL-6 in intestinal mucosa may influence each other among IBS-D patients,both of them may jointly effect the occurrence and development of IBS-D.