Laboratory of Liver, Pancreas and Motility-HIPAM, Department of Experimental Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México-UNAM, México City, México.
Am J Gastroenterol. 2012 May;107(5):747-53. doi: 10.1038/ajg.2011.484. Epub 2012 Jan 24.
Studies suggest that altered immune activation, manifested by an imbalance in anti- and pro-inflammatory cytokine levels, exists in a subgroup of irritable bowel syndrome (IBS) patients. However, similar studies have not been conducted in Latin populations. The objective of this study was to measure serum levels of interleukin (IL)-10 and tumor necrosis factor (TNF)-α in subjects fulfilling symptom criteria for IBS and controls.
Volunteers (n=178) from a university population in Mexico City, participated in the study. Of the sample, 34.8% met Rome II criteria for IBS and 65.2% were designated as controls. Serum cytokines were measured by enzyme-linked immunoabsorbent assay. Analysis of covariance models were used to test main effects between gender, IBS symptoms, and bowel habit subtype to explain the cytokine serum levels. Statistical models were tested using body mass index as a covariate.
IL-10 levels were significantly lower in IBS vs. controls (mean (95% confidence interval): 15.6 (14.8, 16.3) vs. 18.6 (17.9, 19.4) pg/ml, P<0.001), while TNF-α levels were higher in IBS (20.9 (19.1, 23.0) vs. 17.9 (16.7, 19.3) pg/ml, P=0.010). IBS and female gender were independent predictors for IL-10 (P<0.05). In contrast, female gender was an independent predictor for TNF-α. In addition, women with IBS-D had the lowest IL-10 (P<0.001) and highest TNF-α (P=0.021) vs. other subtypes.
The lower serum IL-10 in our subjects fulfilling IBS Rome II symptom criteria suggests an altered immune regulation. Further studies are needed to elucidate if a lower serum IL-10 may be useful as a biomarker for IBS in the Mexican population, especially for women with IBS-D.
研究表明，在一部分肠易激综合征（IBS）患者中存在免疫激活失衡的现象，表现为抗炎细胞因子和促炎细胞因子水平失衡。然而，类似的研究尚未在拉丁人群中进行。本研究的目的是测量符合 IBS 症状标准的受试者和对照者血清中白细胞介素（IL）-10 和肿瘤坏死因子（TNF）-α的水平。
来自墨西哥城一所大学的志愿者参与了这项研究（n=178）。样本中，34.8%符合罗马 II 标准的 IBS 诊断，65.2%为对照者。通过酶联免疫吸附试验测定血清细胞因子。协方差分析模型用于检验性别、IBS 症状和肠习惯亚型对细胞因子血清水平的主要影响。采用体重指数作为协变量对统计模型进行检验。
与对照组相比，IBS 组的 IL-10 水平显著降低（平均值（95%置信区间）：15.6（14.8，16.3）vs. 18.6（17.9，19.4）pg/ml，P<0.001），而 TNF-α 水平在 IBS 组中升高（20.9（19.1，23.0）vs. 17.9（16.7，19.3）pg/ml，P=0.010）。IBS 和女性是 IL-10 的独立预测因子（P<0.05）。相反，女性是 TNF-α 的独立预测因子。此外，IBS-D 女性的 IL-10 最低（P<0.001），TNF-α 最高（P=0.021），与其他亚型相比。
我们的研究对象符合罗马 II 症状标准的 IBS 患者血清中 IL-10 降低提示免疫调节异常。需要进一步研究以阐明血清中较低的 IL-10 是否可作为墨西哥人群中 IBS 的生物标志物，尤其是 IBS-D 女性。
