Clin Gastroenterology H: 克罗恩病患儿血浆Ⅲ型胶原α1链的水平与肠道狭窄发展的关系

2019-08-03 不详 MedSci原创

目前,还没有公认的血清生物标志物可用于鉴定患有狭窄发展风险的克罗恩病(CD)患者。细胞外基质成分——III型胶原α1链(COL3A1)和软骨寡聚基质蛋白(COMP)可能导致肠纤维化。本项研究探究了患有炎症性CD(B1)后来发生狭窄(B2)的儿童,与持续B1的儿童相比,血清中是否增加了COL3A1或COMP的血浆水平。

背景与目的
目前,还没有公认的血清生物标志物可用于鉴定患有狭窄发展风险的克罗恩病(CD)患者。细胞外基质成分——III型胶原α1链(COL3A1)和软骨寡聚基质蛋白(COMP)可能导致肠纤维化。本项研究探究了患有炎症性CD(B1)后来发生狭窄(B2)的儿童,与持续B1的儿童相比,血清中是否增加了COL3A1或COMP的血浆水平。

方法
研究人员选择了161名(平均年龄12.2岁; 62%男性)来自克罗恩病研究队列的儿童,对他们进行快速疾病进展的免疫原性和微生物标记的危险分层和鉴定,所有儿童在诊断时接受结肠镜检查和上消化道内镜检查, 在基线收集血浆样品。基于CD表型,将儿童分为第1组(诊断和随访评估时的B1表型),第2组(诊断时的B2表型)或第3组(在随访评估期间发生狭窄的诊断时的B1表型)。在基线时从患者和40名没有炎性肠病(对照)的儿童收集血浆样品,并通过酶联免疫吸附测定法分析以测量COL3A1和COMP。将这些结果与先前生物标志物研究的结果进行比较。

结果
COL3A1的中位基线浓度与第1组和对照组相比,在第3组中显着升高。COMP的中位基线血浆浓度在各组之间没有显着差异。包含基线浓度的COL3A1和抗CSF2的模型鉴定患有B2与B1 CD的患者,其曲线下面积为0.80(95%CI,0.71-0.89); 联合浓度确定患者的狭窄,敏感值为0.70(95%CI,0.55-0.83),特异性值为0.83(95%CI,0.67-0.93)。

结论
本项研究表明诊断时通过酶联免疫吸附测定法测量的COL3A1的中位血浆浓度显着较高的患者后来发生狭窄可能性更大。COL3A1和抗CSF2浓度的组合可用于鉴定CD诊断中具有狭窄风险的儿科患者。

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