Ciećko-Michalska Irena, Fedak Danuta, Mach Tomasz
Katedra Gastroenterologii i Hepatologii oraz Chorób Zakaźnych UJ Collegium Medicum, Kraków.
Przegl Lek. 2010;67(12):1262-5.
The increase in the incidence of non-specific inflammatory bowel disease (IBD): ulcerative colitis (UC) and Crohn's disease (CD) makes the research of finding new biochemical markers, which were characterized by a high sensitivity and specificity for an objective assessment of severity of the inflammatory process and the effectiveness of treatment of patients. The aim of this study was to estimate the usefulness of neopterin in serum in assessing the disease activity in comparison to other markers of inflammation such as C-reactive protein (CRP) and TNF-alpha in patients with exacerbation of IBD and healthy volunteers. The study included 32 patients with UC and 31 with CD. The control group consisted of 30 healthy volunteers matched for age and gender. Disease activity in patients with UC was assessed based on a point system Mayo. In patients with CD disease activity was calculated based on the CDAI (Crohn's Disease Activity Index). Serum concentrations of neopterin, CRP and TNF-alpha were measured. For determination of CRP were used immunochemical nephelometric method. TNF-alpha and neopterin was measured by ELISA.
In patients with UC and CD increased concentration of serum neopterin was significantly higher compared to the control group (p < 0.005). We observed a positive correlation between increased concentrations of neopterin in serum and increased levels of TNF-alpha and CRP, increasing the number of leukocytes and platelets count and the degree of disease activity in patients with both UC and CD, but was no statistically significant differences between the two groups of patients.
Measurement of neopterin concentration in serum may be a useful marker to assess disease activity in patients with IBD.
非特异性炎症性肠病（IBD）：溃疡性结肠炎（UC）和克罗恩病（CD）的发病率增加，促使人们寻找新的生化标志物，这些标志物具有高敏感性和特异性，可用于客观评估炎症过程的严重程度以及患者的治疗效果。本研究的目的是评估血清中蝶呤与其他炎症标志物如C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）相比，在IBD加重患者和健康志愿者中评估疾病活动度的有用性。该研究纳入了32例UC患者和31例CD患者。对照组由30名年龄和性别匹配的健康志愿者组成。UC患者的疾病活动度根据梅奥评分系统进行评估。CD患者的疾病活动度根据CDAI（克罗恩病活动指数）计算。测定血清中蝶呤、CRP和TNF-α的浓度。CRP的测定采用免疫化学比浊法。TNF-α和蝶呤通过酶联免疫吸附测定法进行测定。
与对照组相比，UC和CD患者血清中蝶呤浓度显著升高（p < 0.005）。我们观察到血清中蝶呤浓度升高与TNF-α和CRP水平升高、白细胞和血小板计数增加以及UC和CD患者的疾病活动度之间呈正相关，但两组患者之间无统计学显著差异。
测定血清中蝶呤浓度可能是评估IBD患者疾病活动度的有用标志物。
