A 23-year-old man is referred to the gastroenterology clinic due to a 3-year history of recurring abdominal pain accompanied by cramps and diarrhea. The patient has noticed an increased frequency of episodes lately with worsening pain. He also says that his urine occasionally appears dark brown and his urine stream sometimes sputters. Imaging studies reveal a colovesical fistula. Biopsy obtained during colonoscopy shows chronic ileocolitis with discontinuous transmural inflammation and noncaseating granulomas. When given the diagnosis of Crohn disease, the patient becomes skeptical and says, "There's no way I'm getting a colostomy bag." He then refuses treatment and pursues a second opinion once his symptoms subside. A second biopsy demonstrates reduced inflammation in regions of previously active ileocolitis. An increase in which of the following cytokines is most likely responsible for this patient's clinical regression?

Question

A 23-year-old man is referred to the gastroenterology clinic due to a 3-year history of recurring abdominal pain accompanied by cramps and diarrhea.  The patient has noticed an increased frequency of episodes lately with worsening pain.  He also says that his urine occasionally appears dark brown and his urine stream sometimes sputters.  Imaging studies reveal a colovesical fistula.  Biopsy obtained during colonoscopy shows chronic ileocolitis with discontinuous transmural inflammation and noncaseating granulomas.  When given the diagnosis of Crohn disease, the patient becomes skeptical and says, "There's no way I'm getting a colostomy bag."  He then refuses treatment and pursues a second opinion once his symptoms subside.  A second biopsy demonstrates reduced inflammation in regions of previously active ileocolitis.  An increase in which of the following cytokines is most likely responsible for this patient's clinical regression?

Quizplus · Accepted Answer

Eductional Objective: Of the cytokines released in the setting of tissue injury, IL-10 plays important anti-inflammatory and immunomodulatory roles, especially in the pathogenesis of inflammatory bowel disease. IL-10 attenuates the immune response through the inhibition of T_H1 cytokines, reduction of major histocompatibility complex class II expression, and suppression of activated macrophages and dendritic cells.

A 23-Year-Old Man Is Referred to the Gastroenterology Clinic Due