Study of Apoptosis and Tissue CD4 in Egyptian Patients with Chronic Colopathy

Colitis is a very common medical problem with a variety of underlying etiologies and overlapping clinical presentations. The problem with chronic colitis is that, these cases may turn into premalignant and malignant lesions. Colorectal cancer is now widely accepted to be the result of accumulation of mutations in specific genes controlling cell division, apoptosis and DNA repair. Apoptosis (programmed cell death) which is a distinct entity from necrosis is an important mechanism that often provides a counter balance to cell proliferation. Indeed the ability of malignant cells to escape the apoptotic mechanisms appears to be critical in the process of oncogenesis. Apoptosis is closely regulated and appears to be directed by a small number of specific genes. T-lymphocytes are important in the immune response, they are divided further into; CD4 Tlymphocytes and CD8 T-lymphocytes. CD4 T- lymphocytes are the principle orchestrators of the immune response. The aim of this stydy is: 1) To detect the sate of apoptosis in a variety of cases of colitis and its relation to the pathogenesis of the disease and its possible role in the prediction of carcinogenesis, 2) Studying the state of CD4-T- lymphocytes in cases of colitis and its relation to apoptosis From patients attending the Tropical Medicine clinics and endoscopy units of Theodor Bilharz Research Institute and Ain Shams University hospital we screened (98) cases complaining of symptoms suggestive of colonic disease for more than one month. These cases were subjected to the to the following: 1) Full clinical history, 2) Thorough clinical examination, 3) Stool analysis 4) Colonoscopy with multiple biopsies stained with H E stain.from the previously mentioned cases, Colonic biopsies from 60 selected cases were subjected to the following: b- TUNEL (immunohistochemical stain for the detection of apoptosis). c- Immunohistochemical stain for the detection of CD4 Tlymphocytes in tissue. We studied the state of apoptosis in different components of the mucosa (epithelium, crypts and lamina propria) in the different histopathological entities of colopathy and colorectal The correlation between the status of apoptosis and CD4 was statistically significant. Conclusion: the status of apoptosis and CD4 varies widely from one histopathological entity of colonic involvement to another and this may have its impact on the pathogenesis of the disease and its progression.