JCC: 粪便髓过氧化物酶可以作为炎症性肠病内镜活动的生物标志物

2022-07-12 xuyihan MedSci原创

炎症性肠病就是指由于环境、遗传、感染、免疫等原因引起的异常免疫介导的肠道炎症,具有慢性、终身复发倾向。临床常见的就是溃疡性结肠炎和克罗恩病。

炎症性肠病 (IBD),包括克罗恩病 (CD) 和溃疡性结肠炎(UC),它的特点是胃肠道的慢性炎症道,估计影响全世界超过680万人。IBD是患者一生都会复发和缓解的疾病,需要定期监测疾病活动。肠道黏膜愈合是 IBD 治疗的当前目标,但是内镜检查由于其侵入性的特点无法大规模普及,另外IBD 的特点是中性粒细胞大量流入肠道。中性粒细胞释放的细胞因子作为准确的生物标志物具有相当大的潜力。

粪便钙卫蛋白 (fCal) 是一种中性粒细胞胞浆蛋白,作为 IBD 中的生物标志物得到了广泛研究。此外髓过氧化物酶 (MPO) 是另一种丰富的中性粒细胞颗粒,MPO通过产生强氧化剂次氯酸,在杀灭细菌和促进炎症组织损伤方面发挥重要作用。本研究的主要目的是探究fMPO是否与IBD 患者的内镜下疾病活动有关。

研究人员前瞻性招募了接受回结肠镜检查的IBD 参与者。将fMPO、C反应蛋白 (CRP) 和粪便钙卫蛋白 (fCal) 与经过验证的内镜指数(CD 的简单内镜评分和 UC 内镜严重程度指数)进行相关性比较。受试者工作特征 (ROC) 曲线评估了 fMPO、CRP 和 fCal 在预测内窥镜疾病活动中的表现。基线生物标志物用于预测 12 个月时复杂疾病的复合终点(由于复发、类固醇使用、IBD 相关住院和手术而需要升级生物/免疫调节剂)。

最后,本项研究共招募了172名参与者(91名女性,100 名患有 CD)。fMPO与CD (r=0.53, p<0.01) 和UC (r=0.63, p<0.01) 以及所有 IBD 患者的 fCal (r=0.82, p<0.01) 的内窥镜活动显着相关。fMPO可有效预测中度至重度活动性 CD (AUROC 0.86, p<0.01) 和 UC (AUROC 0.92, p<0.01)。基线 fMPO >26 µg/g 的个体在 12 个月时更有可能达到复合结局(HR 3.71, 95% CI 2.07-6.64, p<0.01)。

本项研究证实粪便髓过氧化物酶是 IBD 内镜检查活动的准确生物标志物,并可以预测随访期间更复杂的IBD病程进展。

 

原始出处:

A Swaminathan. Et al. Faecal Myeloperoxidase as a Biomarker of Endoscopic Activity in Inflammatory Bowel Disease. Journal of Crohn's and Colitis.2022.

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    2022-07-12 ms7000001124466419

    非常实用

    0

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    2022-07-11 Homburg
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