Decreased Expression of Prox1 Is Associated With Postoperative Recurrence in Crohn's Disease.

Background: Prox1 is a transcription factor necessary for lymphangiogenesis and lymphatic function. The aim of the study was to assess the correlation between the expression of Prox1 and postoperative recurrence in Crohn's Disease (CD).

Methods: Forty CD patients who underwent ileocolonic resection were included. Expression levels of Prox1 and D2-40 were detected using immunohistochemistry. Expression levels of Prox1, VEGFR3, and VEGFC protein were also detected in fresh CD specimens using western blotting and Q-PCR. Endoscopic recurrence was used as the endpoint. Patients comprised two groups: endoscopic recurrence (Group R+) and no endoscopic recurrence (Group R-).

Results: Prox1 protein expression was significantly higher in CD than in normal tissues (P<0.05), as detected using both immunohistochemistry and western blotting. Analysis of interrelationships revealed significant correlation between Prox1 expression and lymphatic vessel density (P<0.001, r = 0.823). There was also significant correlation between Prox1 expression and the visceral fat area (VFA) (P=0.002, r=-0.469). The Group R- patients had significantly higher Prox1 expression than the Group R+ patients (21.08 ±1.61 vs. 15.64 ±1.17, P=0.011). Also, the lymphatic vessel density value was lower in Group R+ than in Group R- patients (6.02 ±0.39 vs. 8.13 ±0.59, P=0.004). Moreover, there was a significant difference in the VFA between Group R- and Group R+ patients (64.43 ±7.76 vs. 90.44 ±6.11, P=0.016). In addition to Prox1, VEGFC/VEGFR3 was found to increase, which was further confirmed using Q-PCR.

Conclusions: Prox1 expression could be useful as a protective factor against recurrence in CD patients. The therapeutic role of Prox1 may lead to improved treatments.