1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Inflamm Bowel Dis. 2011 Mar;17(3):767-77. doi: 10.1002/ibd.21402. Epub 2010 Sep 23.
In inflammatory bowel disease (IBD), enhanced inflammatory activity in the gut is thought to increase the risk of bacterial translocation and endotoxemia. In the present study we investigated the association between serum level of lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14), and clinical disease activity, high-sensitivity C-reactive protein (hs-CRP), antimicrobial serology profile, NOD2/CARD15 status, and clinical phenotype in a large cohort of Hungarian Crohn's disease (CD) patients.
In all, 214 well-characterized, unrelated, consecutive CD patients (male/female ratio: 95/119; age: 35.6 ± 13.1 years; duration:8.3 ± 7.5 years) and 110 healthy controls were investigated. Sera were assayed for LBP, sCD14, hs-CRP, ASCA IgG/IgA, anti-OMP IgA, and pANCA antibodies. NOD2/CARD15 and TLR4 variants were tested. Detailed clinical phenotypes were determined by reviewing the patients' medical charts.
Serum LBP level was significantly higher (P < 0.0001 for both), while sCD14 was lower (P < 0.0001) in both active and inactive CD compared to the controls. The accuracy of hs-CRP (area under the curve [AUC] = 0.66), sCD14 (AUC = 0.70), and LBP (AUC = 0.58) was comparable for identifying patients with active disease. There was a significant correlation between LBP (P < 0.001), sCD14 (P = 0.015), and hs-CRP levels but not with antimicrobial seroreactivity or NOD2/CARD15 genotype. In inactive CD, LBP was associated with penetrating disease. In a Kaplan-Meier analysis and a proportional Cox-regression analysis, LBP (P = 0.006), sCD14 (P = 0.007), and previous relapse frequency (P = 0.023) were independently associated with time to clinical relapse during a 12-month follow-up period.
Serum LBP and sCD14 are markers of disease activity in CD with a similar accuracy as hs-CRP. In addition, LBP, sCD14, and a high frequency of previous relapses were independent predictors for 1-year clinical flare-up. (Inflamm Bowel Dis 2011).
在炎症性肠病（IBD）中，肠道内炎症活性的增强被认为会增加细菌易位和内毒素血症的风险。在本研究中，我们研究了脂多糖结合蛋白（LBP）、可溶性 CD14（sCD14）与临床疾病活动、高敏 C 反应蛋白（hs-CRP）、抗菌血清学特征、NOD2/CARD15 状态和临床表型之间的相关性，纳入了一大组匈牙利克罗恩病（CD）患者。
共研究了 214 名特征明确、无亲缘关系的连续 CD 患者（男/女比例：95/119；年龄：35.6±13.1 岁；病程：8.3±7.5 年）和 110 名健康对照者。检测血清 LBP、sCD14、hs-CRP、抗 ASCA IgG/IgA、抗 OMP IgA 和 pANCA 抗体。检测 NOD2/CARD15 和 TLR4 变异。通过查阅患者病历确定详细的临床表型。
与对照组相比，活动期和非活动期 CD 患者的血清 LBP 水平显著升高（均 P<0.0001），sCD14 水平显著降低（均 P<0.0001）。hs-CRP（曲线下面积[AUC] = 0.66）、sCD14（AUC = 0.70）和 LBP（AUC = 0.58）对识别活动期疾病患者的准确性相当。LBP（P<0.001）、sCD14（P=0.015）与 hs-CRP 水平之间存在显著相关性，但与抗菌血清学反应性或 NOD2/CARD15 基因型无关。在非活动期 CD 患者中，LBP 与穿透性疾病相关。在 Kaplan-Meier 分析和比例 Cox 回归分析中，LBP（P=0.006）、sCD14（P=0.007）和既往复发频率（P=0.023）是 12 个月随访期间临床复发的独立预测因素。
血清 LBP 和 sCD14 是 CD 疾病活动的标志物，其准确性与 hs-CRP 相似。此外，LBP、sCD14 和既往复发频率高是 1 年临床发作的独立预测因素。（炎症性肠病 2011）。
