Analyses of cytokine gene expression and fecal microbiota in a patient with Cronkhite‐Canada syndrome successfully treated with prednisolone

Abstract

Although prednisolone treatment is effective in Cronkhite–Canada syndrome (CCS), its mechanisms of action are poorly understood. We performed analyses of cytokine expression and fecal microbiota in a patient with the concurrent occurrence of CCS and rectal cancer, in whom regression of polyposis was achieved by prednisolone. Regression of CCS polyps was accompanied by downregulation of proinflammatory cytokine expression and alterations in microbiota composition; a decrease in Bacteroides fragilis and Peptostreptococcus anaerobius with the promotion of inflammation. We could not completely exclude the possibility that alterations in fecal microbiota composition might be influenced by the presence of advanced cancer. However, this case suggests that the administration of PSL might lead to the regression of CCS polyps through alterations in gut microbiota composition and suppression of proinflammatory cytokine responses.

Comprehensive treatment and a rare presentation of Cronkhite–Canada syndrome: Two case reports and review of literature

“…Other factors associated with CCS included mental and physical stress[ 6 ], allergy[ 12 ], and gut microbiota[ 16 ]. Discontinuation of allergy-inducing agents, such as hair dyes and certain drugs, was found to reduce IgE concentrations and eosinophil infiltration, as well as to improve clinical symptoms in patients with CCS[ 12 ].…”

“…Discontinuation of allergy-inducing agents, such as hair dyes and certain drugs, was found to reduce IgE concentrations and eosinophil infiltration, as well as to improve clinical symptoms in patients with CCS[ 12 ]. Moreover, the remission and regression of polyps after prednisolone (PSL) treatment of patients with CCS was accompanied by changes in the abundance and diversity of gut microbiota[ 16 ]. PSL can not only inhibit proinflammatory cytokines but can also mediate polyp regression by altering the composition of gut microbiota.…”