SAN FRANCISCO-At last, a raison d’être for the appendix, or rather for its absence. Maybe.
U.S. and Italian teams have reported independently that an appendectomy may raise a protective barrier against development of ulcerative colitis. But a Dutch study, also presented at the American Gastroenterological Association meeting here, cast doubt on them.
In the U.S. study, only 1.3% of 153 ulcerative colitis patients at a community hospital and 1.5% of 1,560 at a university hospital had a history of appendectomy. These rates were significantly lower than the 11.3% of 212 random subjects with no history of colitis or Crohn’s disease, says Dr. John Tasiopoulos of Lutheran General Hospital in Park Ridge, Ill.
In an Italian case-control study, 7.6% of 536 colitis patients had a history of appendectomy, as did 19.9% of 755 controls. The findings were independent of such ulcerative colitis risk factors as smoking or alcohol use, says Dr. Giovanni Monteleone of University Hospital in Catanzaro.
Dr. Tasiopoulos thinks that discovery of a genetic marker might one day permit screening of those at high risk.
Removal of the appendix, which has high helper T-lymphocyte levels, decreases them and boosts suppressor T cells. A prophylactic appendectomy may dampen local autoimmunity in susceptible persons, he says.
But the Dutch study found no association, negative or otherwise, between colitis and appendectomy, says Dr. Maurice Russel of University Hospital in Maastricht. Five percent of 410 patients and 8% of 410 matched controls had a history of the surgery. -Steve Stiles
SAN FRANCISCO-At last, a raison d’être for the appendix, or rather for its absence. Maybe.
