Iltanen Sari, Tervo Laura, Halttunen Tuula, Wei Bo, Braun Jonathan, Rantala Immo, Honkanen Teemu, Kronenberg Mitchell, Cheroutre Hilde, Turovskaya Olga, Autio Ville, Ashorn Merja
Paediatric Research Centre, University of Tampere, Tampere, Finland.
Inflamm Bowel Dis. 2006 May;12(5):389-94. doi: 10.1097/01.MIB.0000218765.84087.42.
Bacteria are implicated as important factors in the pathogenesis of inflammatory bowel disease (IBD). The aim of this study was to seek evidence of possible bacterial targets of the immune response related to IBD in children.
Seventy-eight children referred to the Department of Paediatrics at Tampere University Hospital on suspicion of IBD were included in the study. Upper and lower gastrointestinal endoscopies with biopsies were performed on all children. Sera from 75 children were tested for antibodies to the Pseudomonas fluorescens-associated sequence I2, a Bacteroides caccae TonB-linked outer membrane protein, OmpW, anti-Saccharomyces cerevisiae, and perinuclear anti-neutrophil cytoplasmic antibodies.
The IBD diagnosis was confirmed in 35 children (18 with Crohn's disease [CD], 12 with ulcerative colitis [UC], and 5 with indeterminate colitis [IC]); 43 children were found to have no inflammation in the gut. Forty-three percent (15 of 35) of those with IBD evinced positive seroreactivity to I2 and 46% (16 of 35) to OmpW. In CD, seroreactivity to I2 and OmpW was 50% (9 of 18) and 61% (11 of 18), respectively. Serum anti-I2 and anti-OmpW immunoglobulin A levels were significantly elevated in children with CD in comparison with the non-IBD group (P = 0.007 and P = 0.001, respectively). A combination of OmpW, I2, and anti-S cerevisiae tests identified 94% of CD patients, and a combination of OmpW, I2, and perinuclear anti-neutrophil cytoplasmic antibodies detected 83% of UC cases.
Among children with IBD, strong serological responses to microbial antigens can be found, suggesting that P fluorescens and B caccae antigens have a potential role in the microbiology and immunology of the disease. Furthermore, serologic reactivity to the set of antigens studied here seems to be applicable in the initial differential diagnosis of children with CD and UC.
细菌被认为是炎症性肠病（IBD）发病机制中的重要因素。本研究的目的是寻找与儿童IBD相关的免疫反应可能的细菌靶点的证据。
本研究纳入了78名因疑似IBD转诊至坦佩雷大学医院儿科的儿童。对所有儿童进行了上下消化道内镜检查及活检。检测了75名儿童血清中针对荧光假单胞菌相关序列I2、粪拟杆菌TonB连接外膜蛋白OmpW、抗酿酒酵母抗体和核周抗中性粒细胞胞浆抗体。
35名儿童确诊为IBD（18例克罗恩病[CD]，12例溃疡性结肠炎[UC]，5例未定型结肠炎[IC]）；43名儿童肠道无炎症。IBD患儿中43%（35例中的15例）对I2呈阳性血清反应，46%（35例中的16例）对OmpW呈阳性血清反应。在CD中，对I2和OmpW的血清反应分别为50%（18例中的9例）和61%（18例中的11例）。与非IBD组相比，CD患儿血清抗I2和抗OmpW免疫球蛋白A水平显著升高（分别为P = 0.007和P = 0.001）。OmpW、I2和抗酿酒酵母试验联合可识别94%的CD患者，OmpW、I2和核周抗中性粒细胞胞浆抗体联合检测可发现83%的UC病例。
在IBD患儿中，可发现对微生物抗原的强烈血清学反应，提示荧光假单胞菌和粪拟杆菌抗原在该疾病的微生物学和免疫学中具有潜在作用。此外，对本研究中所研究抗原组的血清学反应似乎适用于CD和UC患儿的初步鉴别诊断。
