Brown Kurt A, Back Susan J, Ruchelli Eduardo D, Markowitz Jonathan, Mascarenhas Maria, Verma Ritu, Piccoli David A, Baldassano Robert N
Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA.
Am J Gastroenterol. 2002 Oct;97(10):2603-8. doi: 10.1111/j.1572-0241.2002.06030.x.
Understanding cytokine production patterns in early mucosal lesions of pediatric patients newly diagnosed with inflammatory bowel disease (IBD) may be critical to understanding IBD pathogenesis. Interleukin-6 (IL-6) has a central role in a multitude of immune system reactions; however, inconsistent lamina propria and serum IL-6 has been reported in IBD patients. Newly diagnosed pediatric IBD patients have not previously been evaluated for lamina propria or serum IL-6.
Serum and intestinal lamina propria biopsy whole organ culture supernatants were evaluated by ELISA for IL-6 obtained from newly diagnosed IBD patients, before initiation of immunomodulatory therapies.
Levels of lamina propria IL-6 demonstrated significant correlation with graded severity of histological inflammation (p < 0.001). Log-transformed serum and organ culture IL-6 levels demonstrated significant correlation (p < 0.0001, R2 = 0.6226). Assigning a demarcation level of >400 pg/ml, serum IL-6 concentrations were a superior marker for the presence of microscopic intestinal inflammation than erythrocyte sedimentation rate (ESR), with a sensitivity of 82%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 82%. When evaluating subtypes of IBD, serum IL-6 levels were correlated more significantly with active disease in ulcerative colitis patients (p = 0.01, R2 = 0.74) than in Crohn's disease patients (p = 0.21, R2 = 0.33).
This study outlines graded production of IL-6 in intestinal lamina propria and serum of newly diagnosed pediatric IBD patients, confirming the presence of IL-6 in early IBD patients. In addition, serum IL-6 may be a good predictor of IBD in pediatric patients with suspected or newly diagnosed IBD.
了解新诊断的炎症性肠病（IBD）儿科患者早期黏膜病变中的细胞因子产生模式，可能对理解IBD发病机制至关重要。白细胞介素-6（IL-6）在众多免疫系统反应中起核心作用；然而，IBD患者的固有层和血清IL-6情况报道不一。此前尚未对新诊断的儿科IBD患者的固有层或血清IL-6进行评估。
通过酶联免疫吸附测定（ELISA）对新诊断的IBD患者在开始免疫调节治疗前获取的血清和肠固有层活检全器官培养上清液中的IL-6进行评估。
固有层IL-6水平与组织学炎症分级严重程度呈显著相关性（p < 0.001）。经对数转换的血清和器官培养IL-6水平呈显著相关性（p < 0.0001，R2 = 0.6226）。设定分界水平>400 pg/ml时，血清IL-6浓度作为微小肠道炎症存在的标志物优于红细胞沉降率（ESR），其灵敏度为82%，特异性为100%，阳性预测值为100%，阴性预测值为82%。在评估IBD亚型时，血清IL-6水平与溃疡性结肠炎患者的活动期疾病相关性更显著（p = 0.01，R2 = 0.74），而与克罗恩病患者的相关性较弱（p = 0.21，R2 = 0.33）。
本研究概述了新诊断的儿科IBD患者肠固有层和血清中IL-6的分级产生情况，证实早期IBD患者中存在IL-6。此外，血清IL-6可能是疑似或新诊断IBD的儿科患者IBD的良好预测指标。
