Musosal tumour necrosis factor α in diverticular disease of the colon is overexpressed with disease severity

Aim Inflammation occurs in diverticular disease (DD), but there is little information on inflammatory cytokines such as tumour necrosis factor a (TNF-a). The aim of this study was to assess TNF-a expression in DD and to see whether it is related to the severity of the disease. Method Twenty-four patients with symptomatic DD were divided into those with acute uncomplicated diverticulitis (AUD) (12 patients) and those with symptomatic uncomplicated diverticular disease (SUDD) (12 patients). Twelve further patients with asymptomatic diverticulosis (AD), six with segmental colitis associated with diverticulosis (SCAD), with ulcerative colitis (UC) and six healthy individuals (HC) were enrolled as controls. TNF-a expression in the colonic mucosa was assessed by the amount of mRNA codifying for the synthesis of TNF-a. Results TNF-a expression was significantly higher in AUD than in HC (P = 0.0007), in AD (P = 0.0001) and in SUDD (P = 0.0179). It was significantly higher also in SUDD than in HC (P = 0.0007) and in AD (P = 0.0001). TNF-a expression in AUD did not differ significantly from that in UC (P = 0.0678) and SCAD (P = 0.0610). It was significantly higher in UC, SCAD and AUD than in SUDD (P = 0.0007, P = 0.0001, P = 0.0179). Conclusion TNF-a expression in DD seems to be related to the severity of the disease. In particular, it appears to be overexpressed in DD with inflammation (AUD and SUDD) compared with DD without (AD).