Medical Abstract
Potential Viral Pathogenic Mechanism for New Variant Inflammatory Bowel Disease

2002 abstract: inflammatory bowel disorder and developmental delay
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Potential Viral Pathogenic Mechanism For New Variant Inflammatory Bowel Disease

V Uhlmann*, C M Martin*, O Sheils, L Pilkington, I Silva, A Killalea, S B Murch,
A J Wakefield, J J O'Leary,
J Clin Pathol: Mol Pathol 2002; 55: 0" 6

Aims: A new form of inflammatory bowel disease (ileocolonic hyperplasia) has been described in a cohort of children with developmental disorder. This study investigates the presence of persistent measles virus in the intestinal tissue of these patients (new variant inflammatory bowel disease) and a series of controls by molecular analysis.
Methods: Formalin fixed, paraffin wax embedded and fresh frozen biopsies from the terminal ileum were examined from affected children and histological normal controls. The measles virus Fusion (F) and Haemagglutinin (H) genes were detected by TaqMan reverse transcription polymerase chain reac_tion (RT_PCR) and the Nucleocapsid (N) gene by RT in situ PCR. Localisation of the mRNA signal was performed using a specific follicular dendritic cell antibody.
Results: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lym_phocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ ng total RNA.
Conclusions: The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder. An apparently new form of immune mediated inflammatory bowel disease in a cohort of children with developmental disorder has been described.
1. The intestinal pathology includes ileocolonic lymphonodular hyperplasia and non-specific colitis, which manifests as neither Crohn's disease nor ulcerative colitis. The histological and clinical aspects of this new disorder have been reported previously.
2. It has been postulated that reactive follicular hyperplasia in ileal tissue biopsies of affected children may reflect the persistence of viral antigen at this site. 2 Preliminary immunohisto-chemicaldata suggested the presence of measles virus (MV) antigen in the extracellular matrix of the midgut mucosal lymphoid tissue in affected children. 2 MV belongs to the family of single stranded paramyxoviruses. It is the causative agent for several diseases including subacute sclerosing panencephalitis (SSPE) and measles inclusion body encephalitis.
3. Measles ranked as one of the leading causes of childhood mortality in the late 20th century.
4. In developing countries, 1 million deaths each year are related to MV infections. "Measles virus is the causative agent for several diseases including subacute sclerosing panencephalitis and measles inclusion body encephalitis". Our study examines a possible association between MV and the above condition. To achieve this aim, several molecular biological techniques have been used to identify, localise, and measure MV from terminal ileum biopsies in children with ileocolonic lymphonodular hyperplasia and developmental disorder.

The link for the entire paper is:
http://jcp.bmjjournals.com/cgi/content/full/55/1/DC1?eaf

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