骨保护素在小儿克罗恩病中的作用及肠内营养的影响。
Osteoprotegerin in pediatric Crohn's disease and the effects of exclusive enteral nutrition.
机构信息
School of Women's and Children's Health, University of New South Wales, Department of Gastroenterology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia.
出版信息
Inflamm Bowel Dis. 2011 Feb;17(2):516-23. doi: 10.1002/ibd.21361.
BACKGROUND
Osteoprotegerin (OPG) may have proinflammatory roles in addition to its contribution to the maintenance of bone mass. Exclusive enteral nutrition (EEN) is an established therapy for the induction of remission in Crohn's disease (CD). The aims of this study were to ascertain serum, fecal, and mucosal expression of OPG in children with CD and to investigate the effects of EEN on OPG expression.
METHODS
OPG was measured by enzyme-linked immunosorbent assay in serum, mucosal, and fecal samples collected from children with CD and controls. Fecal and Serum OPG was measured prior to and following 6-8 weeks of EEN therapy.
RESULTS
Children with CD (n=82) and controls (n=45) were included. Mucosal and fecal OPG levels were elevated in CD compared to controls (P=0.018 and P<0.0001, respectively). Serum OPG was elevated in children with severe CD (P=0.005). Serum and fecal OPG levels dropped significantly following EEN therapy (P=0.0001 and P=0.002, respectively).
CONCLUSIONS
Increased serum and fecal OPG are seen in active CD and likely originate from the inflamed gut. Fecal and serum OPG decrease following EEN therapy. Further investigation of OPG and related proteins in the setting of IBD is now required.
背景
骨保护素（OPG）除了有助于维持骨量外，还可能具有促炎作用。完全肠内营养（EEN）是诱导克罗恩病（CD）缓解的既定疗法。本研究的目的是确定 CD 患儿血清、粪便和黏膜中 OPG 的表达，并研究 EEN 对 OPG 表达的影响。
方法
采用酶联免疫吸附试验（ELISA）检测 CD 患儿和对照组血清、黏膜和粪便样本中的 OPG。在 EEN 治疗前和治疗 6-8 周后分别测量粪便和血清 OPG。
结果
共纳入 82 例 CD 患儿和 45 例对照组。与对照组相比，CD 患儿的黏膜和粪便 OPG 水平升高（P=0.018 和 P<0.0001）。严重 CD 患儿的血清 OPG 升高（P=0.005）。EEN 治疗后血清和粪便 OPG 水平显著下降（P=0.0001 和 P=0.002）。
结论
活动期 CD 患者中可见血清和粪便 OPG 升高，可能源自炎症肠道。EEN 治疗后粪便和血清 OPG 下降。现在需要进一步研究 IBD 中 OPG 和相关蛋白。
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