Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Japan.
Aliment Pharmacol Ther. 2011 Oct;34(8):941-8. doi: 10.1111/j.1365-2036.2011.04805.x. Epub 2011 Aug 16.
Chitinase 3-like-1 (CHI3L1) is up-regulated in the inflamed mucosa of inflammatory bowel disease (IBD).
To evaluate the usefulness of a faecal CHI3L1 assay, as a reliable marker for predicting the severity of paediatric IBD.
Faecal samples were obtained from ulcerative colitis (UC, n = 94), Crohn's disease (CD, n = 87), and healthy individuals (n = 56). The faecal CHI3L1 and calprotectin levels were determined by ELISA. For endoscopic evaluation, the sum of the Matts' score for UC and the simple endoscopic score for CD (SES-CD) were used. Ileal lesions were evaluated by ultrasonography.
Faecal CHI3L1 levels were significantly elevated in active UC (median 366.6 ng/g, n = 44) and active CD (median 632.7 ng/g, n = 48) patients, as compared with healthy individuals (median 2.2 ng/g, n = 56). In UC patients, the faecal CHI3L1 levels were positively correlated with the sum of the Matts' score (r = 0.73, P < 0.01, n = 42). In CD patients, there was a significant correlation between faecal CHI3L1 levels and endoscopic activity as determined by the SES-CD scoring system (r = 0.61, P < 0.01, n = 25). The faecal CHI3L1 levels of patients with wall thickening of their small intestine were significantly higher than those of healthy controls or patients without wall thickening. The cutoff value of 13.7 ng/g for fecal CHI3L1(the 95th percentile of the control value) predicted active lesions in IBD patients with a sensitivity of 84.7% and a specificity of 88.9%.
Faecal CHI3L1 assays may be useful for predicting the severity and activity of mucosal inflammation in IBD.
几丁质酶 3 样蛋白 1（CHI3L1）在炎症性肠病（IBD）的炎症黏膜中上调。
评估粪便 CHI3L1 检测作为预测儿科 IBD 严重程度的可靠标志物的效用。
从溃疡性结肠炎（UC，n=94）、克罗恩病（CD，n=87）和健康个体（n=56）中获得粪便样本。通过 ELISA 测定粪便 CHI3L1 和钙卫蛋白水平。对于内镜评估，使用 UC 的 Matt's 评分总和和 CD 的简单内镜评分（SES-CD）。通过超声评估回肠病变。
与健康个体（n=56）相比，活动期 UC（n=44）和活动期 CD（n=48）患者的粪便 CHI3L1 水平显著升高（中位数分别为 366.6 ng/g 和 632.7 ng/g）。在 UC 患者中，粪便 CHI3L1 水平与 Matt's 评分总和呈正相关（r=0.73，P<0.01，n=42）。在 CD 患者中，粪便 CHI3L1 水平与 SES-CD 评分系统确定的内镜活动之间存在显著相关性（r=0.61，P<0.01，n=25）。小肠壁增厚患者的粪便 CHI3L1 水平明显高于健康对照者或无壁增厚患者。粪便 CHI3L1 水平为 13.7 ng/g（对照值第 95 百分位数）的截断值预测 IBD 患者的活动性病变，其敏感性为 84.7%，特异性为 88.9%。
粪便 CHI3L1 检测可能有助于预测 IBD 患者黏膜炎症的严重程度和活动度。
