Investigation of Crohn's Disease by Immunohistochemistry Technique in Iraqi Patients

Abstract

Crohn's disease (CD) is one of the most common IBD types. CD necessitates an erratic immune response. Previous research has shown that inflammation of the intestines is elevated or continues due to inappropriate immune responses that result from the relationships between environmental factors, intestinal microbiota, and genetic factors. Induces intense transmural inflammation. This study aimed to investigate (i) CD detection by Histopathology and Immunohistochemistry (IHC) Markers that are Mycobacterium avium subspecies paratuberculosis MAP antibody and TWEAK/Fn14 antibody and their association with CD. (ii) Prove or disprove the hypothesis of MAP as a potential cause of CD. Tissue biopsies of 30 cases with a recognized diagnosis of CD and 20 cases as control presented without disease symptoms were collected. They are 20 males and 10 females for patients, and 13 males and 7 females for control with ages ranging from 9-55(±34.78) years. From 2019 - 2020, Biopsies were collected from Medical City Hospitals in Baghdad. One tissue section has been stained by the Hematoxylin & Eosin (H&E) for histopathology examinations. IHC stained the other two sections to the markers mentioned earlier in the IHC technique. The results of IHC for MAP showed a highly significant relationship in the ileal tissues of patients with disease CD with varying degrees according to the intensity of the immune reaction, which represents the intensity of the color, which is distributed between weak, moderate and strong, according to the (Aperio image Scope) program. Where it was 10% weak, 43.33% medium, and 46.67% strong. The P-value for patients vs. control was 0.0052 and 0.0001, respectively (P-value 0 ≤ 0.01). The result of IHC proves the hypothesis of MAP as a potential cause of CD. The other effects of IHC staining for TWEAK/Fn14 marker showed a highly significant relationship in the ileal tissues of patients with Crohn's Disease with varying degrees according to the intensity of the immune reaction, according to the Aperio image Scope program. It was 10% weak, 36.67% medium, and 53.33% strong. P-value for patients vs control were 0.0003 and 0.0001, respectively (P-value 0 ≤ 0.01).