Re: A hypothesis on inflammation and cholestasis/Deb

[Guest guest]

Hi Deb;

I wish I knew the answer to your question (which is a very good one I

might add)! When was a young child (a few months old) he was

very sick with an unexplained colitis, eventually leading to

bacterial meningits, requiring antibiotics. This occurred following a

DPT vaccination. I have wondered whether this was somehow related to

his more recent diagnosis of PSC/UC? It sounds like your question is

very similar ... did an early childhood infection/sepsis subsequently

result in IBD/PSC?

The only possible explanation that I can come up with is that a very

serious infection (and sepsis) might lead to production of antibodies

that impair the ability to deal with subsequent infections. For

instance, one of the key proteins involved in detoxifying

lipopolysaccharide (produced by Gram-negative bacteria during sepsis)

is the bacterial/permeability increasing protein. Antibodies to this

protein can occur in several diseases, including cystic fibrosis,

inflammatory bowel disease, and PSC. Perhaps a very serious infection

(sepsis) could lead to production of antibodies to

bacterial/permeability increasing protein which then leads to

susceptibility to subsequent infections and/or inflammatory bowel

disease/PSC?

But this recent paper suggests that there is no simple relationship

between early life events and PSC:

World J Gastroenterol. 2006 Oct 7;12(37):6037-40.

Perinatal events and the risk of developing primary sclerosing

cholangitis.

Bergquist A, Montgomery SM, Lund U, Ekbom A, Olsson R, Lindgren S,

Prytz H, Hultcrantz R, Broome U

Department of Gastroenterology and Hepatology, Karolinska University

Hospital, Huddinge, Karolinska Institute, Stockholm, Sweden.

annika.bergquist@....

AIM: To investigate whether perinatal events, intrauterine or

postpartum, are associated with the development of primary sclerosing

cholangitis (PSC) later in life. METHODS: Birth records from 97

patients with adult PSC in Sweden were reviewed. Information on

perinatal events including medications and complications during

pregnancy, gestation length, birth weight and length were collected.

Two control children of the same sex were selected for each subject.

Conditional multiple logistic regression was used to assess

associations of the perinatal measures with development of PSC.

RESULTS: No significant associations were found between gestational

age, birth length, breastfeeding, and the majority of medical

complications including infections or medication during pregnancy for

the mothers or postpartum for the children. Vaginal bleeding and

peripheral oedema showed associations with PSC, with matched odds

ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03),

respectively. CONCLUSION: The associations of vaginal bleeding and

oedema with subsequent PSC cannot readily be explained, so our

findings do not strongly support the hypothesis of a significant role

of perinatal events as a risk for the development of PSC later in

life. PMID: 17009405

http://www.wjgnet.com/1007-9327/12/6037.asp

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)

[Guest guest]

-----Original

Message-----

CONCLUSION: The

associations of vaginal bleeding and oedema with subsequent PSC cannot readily

be explained, so our

findings do not strongly support the hypothesis of a significant role of

perinatal events as a risk for the development of PSC later in life.

Ken was as healthy

as can be during childhood. He had

chicken pox, but at best, for only a few days and with so few

pox it could have easily gone unnoticed. A few other childhood

things, but again very minor.

Mono about 10–12 yrs old that hung around longer then they thought

it should, otherwise a healthy boy.

Except….. he did have a hernia with surgery

around 18-22 months. I don’t remember

him receiving antibiotics (it was 32 years ago), but they might have been given.

On the other hand……I

had staining/spotting for the first 3 months of pregnancy, we thought I’d

lose him. And during labor I hemorrhaged. Hmmmm….. Anyone

else?

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

_._,___

[Guest guest]

-----Original

Message-----

CONCLUSION: The

associations of vaginal bleeding and oedema with subsequent PSC cannot readily

be explained, so our

findings do not strongly support the hypothesis of a significant role of

perinatal events as a risk for the development of PSC later in life.

Ken was as healthy

as can be during childhood. He had

chicken pox, but at best, for only a few days and with so few

pox it could have easily gone unnoticed. A few other childhood

things, but again very minor.

Mono about 10–12 yrs old that hung around longer then they thought

it should, otherwise a healthy boy.

Except….. he did have a hernia with surgery

around 18-22 months. I don’t remember

him receiving antibiotics (it was 32 years ago), but they might have been given.

On the other hand……I

had staining/spotting for the first 3 months of pregnancy, we thought I’d

lose him. And during labor I hemorrhaged. Hmmmm….. Anyone

else?

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

_._,___

[Guest guest]

-----Original

Message-----

CONCLUSION: The

associations of vaginal bleeding and oedema with subsequent PSC cannot readily

be explained, so our

findings do not strongly support the hypothesis of a significant role of

perinatal events as a risk for the development of PSC later in life.

Ken was as healthy

as can be during childhood. He had

chicken pox, but at best, for only a few days and with so few

pox it could have easily gone unnoticed. A few other childhood

things, but again very minor.

Mono about 10–12 yrs old that hung around longer then they thought

it should, otherwise a healthy boy.

Except….. he did have a hernia with surgery

around 18-22 months. I don’t remember

him receiving antibiotics (it was 32 years ago), but they might have been given.

On the other hand……I

had staining/spotting for the first 3 months of pregnancy, we thought I’d

lose him. And during labor I hemorrhaged. Hmmmm….. Anyone

else?

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

_._,___