血清可溶性白细胞介素-2 受体、白细胞介素-6 和肿瘤坏死因子-α 作为乳糜泻活动的标志物。
Serum soluble interleukin-2 receptor, interleukin-6 and tumor necrosis factor alpha as markers of celiac disease activity.
机构信息
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India.
出版信息
Indian J Pediatr. 2013 Feb;80(2):108-13. doi: 10.1007/s12098-012-0830-9. Epub 2012 Jul 6.
OBJECTIVES
To evaluate the markers of lymphocyte activation (sIL-2R, IL-6 and TNF α) in the peripheral blood of newly diagnosed patients with celiac disease (CD) and patients with CD on Gluten free diet (GFD) for at least 2 y. The markers were correlated with conventional serological tests Anti-tissue transglutaminase (Anti-TTG) used for diagnosis and follow up of the disease; wherever possible.
METHODS
Thirty newly diagnosed cases of CD (on the basis of histopathology and serology) not on GFD were enrolled as Group 1 of the study. Thirty age and sex matched controls from the Pediatric Surgery OPD formed Group 2. Thirty cases of CD on GFD for at least 2 y (Group 3) were also enrolled in the study. Upper G.I. endoscopy was performed in all Group 1 patients and cytokine levels assayed by ELISA on serum obtained from all patients in Groups 1, 2, 3.
RESULTS
Mean sIL-2R level in Group 1(1498.1+/-1234.31 pg/ml) and Group 3 (488.78+/-396.18 pg/ml) were significantly higher than the controls (336.27+/-218.67 pg/ml p < 0.05). Among the patients with CD, mean serum levels in Group 1 were higher than in Group 3 (p < 0.05). sIL-2R levels showed good correlation with tTg levels in Group 1 patients (p < 0.000, r = 0.69). Mean IL-6 levels in Group 1 were significantly higher (28.43+/-28.32 pg/ml) than Group 2(15.03+/-7.72 pg/ml p < 0.05) and Group 3(11.26+/-5.13 pg/ml p < 0.05). IL-6 levels were comparable between Groups 2 and 3 (p > 0.05).IL-6 levels showed good correlation with tTg levels in Group 1(p < 0.008, r = 0.471). Mean TNFα levels in Group 1(179.66+/-102.93 pg/ml), Group 2 (153.16+/-27.02 pg/ml) and Group 3 (166.67+/-28.95 pg/ml) were comparable (p > 0.05). TNFα levels showed poor correlation with tTg levels in Group 1 patients (p > 0.604, r = -0.099).
CONCLUSIONS
sIL-2R and IL-6 levels have a good correlation with CD activity and can be used as reliable markers for detecting minimal transgression from GFD.
目的
评估新诊断的乳糜泻（CD）患者和接受无麸质饮食（GFD）治疗至少 2 年的 CD 患者外周血中淋巴细胞活化标志物（sIL-2R、IL-6 和 TNFα）。这些标志物与用于诊断和随访疾病的常规血清学检测抗组织转谷氨酰胺酶（Anti-TTG）进行了尽可能的相关性分析。
方法
将 30 例新诊断的 CD 患者（基于组织病理学和血清学）纳入研究的第 1 组，这些患者未接受 GFD。第 2 组为儿科外科门诊的 30 名年龄和性别匹配的对照组。第 3 组还纳入了 30 例接受 GFD 治疗至少 2 年的 CD 患者。对第 1 组所有患者进行上胃肠道内镜检查，并对第 1、2、3 组所有患者的血清进行 ELISA 检测细胞因子水平。
结果
第 1 组（1498.1±1234.31 pg/ml）和第 3 组（488.78±396.18 pg/ml）的平均 sIL-2R 水平明显高于对照组（336.27±218.67 pg/ml，p<0.05）。在 CD 患者中，第 1 组的血清水平高于第 3 组（p<0.05）。第 1 组患者的 sIL-2R 水平与 tTg 水平呈良好相关性（p<0.000，r=0.69）。第 1 组的平均 IL-6 水平明显高于第 2 组（28.43±28.32 pg/ml）和第 3 组（11.26±5.13 pg/ml，p<0.05）。第 2 组和第 3 组的 IL-6 水平相当（p>0.05）。第 1 组的 IL-6 水平与 tTg 水平呈良好相关性（p<0.008，r=0.471）。第 1 组（179.66±102.93 pg/ml）、第 2 组（153.16±27.02 pg/ml）和第 3 组（166.67±28.95 pg/ml）的平均 TNFα 水平相当（p>0.05）。第 1 组患者的 TNFα 水平与 tTg 水平相关性较差（p>0.604，r=-0.099）。
结论
sIL-2R 和 IL-6 水平与 CD 活动有良好的相关性，可以作为检测从 GFD 微小偏差的可靠标志物。
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