[The treatment of Crohn's disease depending on the activity and location of the process].
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Biomedical subjects
Publications and source records attributed to M Kh Levitan.
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The cAMP level and the activity of cAMP-dependent and independent protein kinases were measured in adenomatous polyps, villous polyps (premalignant condition) and adenocarcinomas. The cAMP concentration and ratio of cAMP level versus cAMP-independent casein kinase activity were significantly lower in adenocarcinomas compared to adenomatous polyps, thus permitting differentiation between benign and malignant lesions. The cAMP versus cAMP-dependent histone kinase level ratio was used as a test for differentiation between malignancies and premalignant condition. It was markedly lower in adenocarcinomas than in villous polyps.
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Histological, morphometric, and immunohistochemical studies (with detection of the local production of IgA, IgM, IgG, IgE, and IgD, secretory component of IgA, and deposition of the third complement component, C3) were carried out on biopsies of the colon mucosa from 66 patients with recurrent and continuous forms of nonspecific ulcerative colitis and 16 patients with Crohn's disease. Inflammation in the colon mucosa in the diseases under study was found to be accompanied by marked activation of the local immune system, increased local production of IgA and IgM as well as IgG, particularly in those parts of the mucosa which had no glands. Local synthesis of IgE and IgD also increases indicating allergic reaction in the mucosa alongside with tissue eosinophilia. The basal membrane of the surface epithelium was found to have C3 depositions. A typical feature was the lack of correlation between infiltration of the layer proper of the mucosa and epithelium which is regarded to be a manifestation of deficiency of T-lymphocytes (subpopulation of suppressors or lymphocytes taking part in regulation of epithelium regeneration).
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Two rare observations in which villous tumors affected the mucous membranes of the rectum and transverse colon are described. In one case the lesions extended for 60 cm, in the other the neoplasm occupied the entire inner surface of the rectum and colon as well as the adjacent area of the ileum, whereas in the area of the liver and spleen bends there were areas of adenocarcinoma. Both observations were characterized by marked inflammatory infiltration in some parts of the villous tumor.
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