De Simone Matilde, Ciulla Michele M, Cioffi Ugo, Poggi Luca, Oreggia Barbara, Paliotti Roberta, Botti Fiorenzo, Carrara Alberto, Agosti Fiorenza, Sartorio Alessandro, Contessini-Avesani Ettore
Department of Surgery, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy.
J Gastrointest Surg. 2007 Oct;11(10):1361-4. doi: 10.1007/s11605-007-0233-9. Epub 2007 Aug 9.
This study investigates the effects of surgery on collagen turnover in patients affected by Crohn's disease (CD).
Fifteen patients affected by active CD, assessed according to the Crohn's disease activity index, and confirmed by histology, with different pharmacological treatments, were enrolled in the study. N-Terminal propeptide of type III collagen was assessed on peripheral blood before and 6 months after surgery, as an index of collagen turnover. A control group of 15 healthy age- and sex-matched subjects was also studied.
In CD patients peripheral N-terminal propeptide of type III collagen serum levels were significantly higher than in controls before surgery (5.0 +/- 1.8 vs 2.7 +/- 0.7 microg/l, respectively; p = 0.0001). Six months after these values were significantly reduced (from 5.0 +/- 1.8 to 3.1 +/- 0.8 microg/l; p = 0.003). Independently on the pretreatment regimen and the duration of the disease, an improvement in the patients' symptoms was observed.
The surgical resection of the affected intestinal segment in CD patients seems to be able to break down the collagen synthesis processes. Peripheral N-terminal propeptide of type III collagen could be seen as an additive marker to clinical and endoscopic observations after surgery.
本研究调查手术对克罗恩病(CD)患者胶原转换的影响。
根据克罗恩病活动指数评估并经组织学确认,纳入15例接受不同药物治疗的活动期CD患者。术前及术后6个月检测外周血中III型胶原N端前肽,作为胶原转换指标。同时研究15例年龄和性别匹配的健康对照者。
CD患者术前外周血III型胶原N端前肽血清水平显著高于对照组(分别为5.0±1.8与2.7±0.7μg/L;p = 0.0001)。6个月后这些值显著降低(从5.0±1.8降至3.1±0.8μg/L;p = 0.003)。无论术前治疗方案和病程长短,患者症状均有改善。
CD患者病变肠段的手术切除似乎能够打破胶原合成过程。外周血III型胶原N端前肽可被视为术后临床和内镜观察的补充标志物。