[Activation of the major omentum-associated lymphoid tissue in Crohn disease].

S Schreiber, A Gehrckens, A Raedler
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Zentralblatt für Chirurgie
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The mucosa associated lymphoid tissues of the intestinal lamina propria or the bronchial mucosa, respectively, represent a separated and well defined immunologic compartment. Due to highly specialized functions, subpopulations of lymphoid cells are distributed unevenly between the compartments and unique regulatory mechanisms developed to sustain integrity of mucosal surfaces. With this study we investigate whether an omentum associated lymphoid tissue exists and whether it partakes in immunologic processes involved in the perpetuative intestinal inflammation in Crohn''s disease. Mononuclear cells from surgically resected omentum tissue (10 patients with Crohn''s disease, 10 patients with malignomas or inflammatory control diseases (diverticulitis)) were isolated by collagenase digestion and subsequent serial density centrifugation. Phenotypic analysis was carried out by immunofluorescent labeling with a panel of monoclonal antibodies as well as peanut agglutinin. Most interestingly, the percentage of CD4-T(Helper) cells among omentum mononuclear cells was decreased in comparison with peripheral blood mononuclear cells, whereas the percentage of monocytes/macrophages and of natural killer cells appeared to be increased. In comparison with normal peripheral blood a higher percentage of normal omentum mononuclear cells were activated. It thus appears that a defined immunologic compartment exists which is different in its cellular composition from peripheral blood as well as from intestinal mucosa associated lymphoid tissue and which may be called omentum associated lymphoid tissue. In Crohn''s disease subpopulations of omentum mononuclear cells did not change in number, however immunologic activation increased further and appears to be highly increased in comparison to both omentum cells from disease specificity controls (diverticulitis) and Crohn''s disease peripheral blood cells. We conclude that omentum associated lymphoid tissue may be described as an unique immunologic compartment which may play a role in activating events in chronic intestinal inflammation in Crohn''s disease. Further studies will address functional characteristics of the omentum associated lymphoid tissue and will investigate regulatory mechanisms which may contribute to the inflammatory process in Crohn''s disease.