Proujansky R, Carpenter A B
Department of Pediatrics, University of Pittsburgh School of Medicine, Pennsylvania.
J Pediatr Gastroenterol Nutr. 1991 Oct;13(3):277-84. doi: 10.1097/00005176-199110000-00007.
Serum concentrations of the soluble form of the interleukin-2 receptor (sIL-2R) were determined by an enzyme-linked immunosorbent assay in a group of 39 pediatric and adolescent patients with Crohn's disease and in age-matched ulcerative colitis patients and controls. sIL-2R levels were found to be elevated in patients with Crohn's disease (p less than 0.001), and increased sIL-2R levels were detected in patients with clinically more severe disease. sIL-2R levels correlated more closely with other laboratory markers of disease activity than with a disease activity score. A progressive increase in sIL-2R levels was noted to correlate with endoscopic measurement of disease extent, while sIL-2R levels did not correlate with other markers of systemic lymphocyte activation, suggesting possible local mucosal production. Sequential determinations in individual patients revealed a good correlation between sIL-2R and clinical course. More important, elevated levels of sIL-2R preceded clinical relapse of asymptomatic patients. We conclude that sIL-2R measurement may be a useful adjunct to clinical assessment and routine laboratory testing in pediatric and adolescent patients with Crohn's disease and that serial levels may be predictive of clinical course and the response to therapy.
采用酶联免疫吸附测定法，对39例克罗恩病患儿及青少年患者、年龄匹配的溃疡性结肠炎患者和对照组患者测定血清中白细胞介素-2受体可溶性形式（sIL-2R）的浓度。发现克罗恩病患者的sIL-2R水平升高（p<0.001），且临床病情较重的患者sIL-2R水平升高。与疾病活动评分相比，sIL-2R水平与疾病活动的其他实验室指标相关性更密切。sIL-2R水平的逐渐升高与疾病范围的内镜测量结果相关，而sIL-2R水平与全身淋巴细胞激活的其他指标无关，提示可能是局部黏膜产生。对个体患者进行连续测定发现，sIL-2R与临床病程之间具有良好的相关性。更重要的是，无症状患者临床复发之前sIL-2R水平升高。我们得出结论，在患有克罗恩病的儿童和青少年患者中，测定sIL-2R可能是临床评估和常规实验室检测的有用辅助手段，连续测定的水平可能预测临床病程和对治疗的反应。
