Connexin 37, 40, 43 and Pannexin 1 Expression in the Gastric Mucosa of Patients with Systemic Sclerosis.

Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs. Although its pathogenesis is not fully understood, connexins (Cxs) and pannexins (Panx) could be involved in the process of fibrosis. We analyzed the protein expression of Cx37, Cx40, Cx43, and Panx1 in the gastric mucosa of patients with SSc and healthy volunteers, using immunofluorescence staining. Protein levels of Cx37 were slightly increased, while the levels of Cx40 were significantly decreased in the lamina propria of the gastric mucosa of SSc patients compared to the controls. The changes were proportional to SSc severity, with the most prominent changes found in patients with severe diffuse cutaneous SSc. No differences in Cx43 or Panx1 levels were found between the analyzed groups of samples. The lack of changes in Cx43 expression, which has been previously associated with fibrosis, could be due to the weak expression of Cx43 in the gastric mucosa in general. Further studies on full-thickness gastric biopsies containing muscle layers and animal SSc models are needed to fully elucidate the role of Cxs and Panxs in SSc-associated fibrosis.

Obstructive Giant Inflammatory Polyposis as a First Manifestation of Crohn's Disease: A Case Report.

Colonic inflammatory polyps (pseudopolyps) are common feature of inflammatory bowel diseases. They usually do not grow excessively, rarely reaching more than 15 mm in size, at which point they are termed giant inflammatory polyps. Clinical presentation of these polyps can vary greatly, ranging from being completely asymptomatic, usually detected incidentally, to abdominal cramps, rectal bleeding or intestinal obstruction. More importantly, giant inflammatory polyps can be easily mistaken for colonic malignancy, although without having malignant potential themselves. These polyps rarely regress with successful medical treatment of inflammatory bowel diseases and often require surgical treatment. We present an unusual case of giant inflammatory polyps which was the first presentation of inflammatory bowel disease. It was initially mistaken for colonic malignancy with intestinal obstruction, which led to surgical treatment.