Boldyreva O N
Eksp Klin Gastroenterol. 2012(5):119-25.
One of the key links of pathological inflammatory process is the formation factors of adhesion. They play a leading role in the formation of inflammatory infiltration of the mucosa of the colon. Changes in the levels factors of adhesion under the influence of biological therapy are not well understood. In this regard, the aim of our study was to investigate the influence of biological therapy (infliximab, mesenchymal stromal cells) on the level of adhesion molecules in patients with IBD. Investigated the role of adhesion molecules to evaluate the effectiveness of treatment in this group of patients. Was examined 30 patients with IBD. Of these, 16 patients with ulcerative colitis (UC) and 14 patients with Crohn's disease (CD). Of these, 16 patients received infliximab 5 mg/kg body weight, 14 patients with IBD who underwent a comprehensive anti-inflammatory therapy with the introduction of MSC culture. Before and after treatment with infliximab, MSC transplantation was carried out a study of the clinical blood test, CRP, determined by the level of adhesion molecule L-selectin, E-selectin, P-selectin, integrin - sVCAM-1 in serum by ELISA Under the influence of infliximab for all IBD patients had significantly lower levels of P-selectin, E-selectin, integrin - sVCAM-1. In the group of patients after MSC transplantation rates of P-selectin, E-selectin was significantly decreased and the level of integrin - sVCAM-1 decreased slightly. The level of L-selectin in patients both after MSC transplantation and therapy with infliximab is practically not reduced, which serves as a reflection of chronic autoimmune inflammation, and the basis for long-term use of biological therapy in IBD. Adhesion molecule P-selectin, E-selectin, integrin - sVCAM-1 decreased more rapidly under the influence of infliximab in patients with IBD because of the mechanism of drug action (suppression of the synthesis of core inflammatory cytokine TNF-alpha). After transplantation of MSCs P-selectin, E-selectin, integrin - sVCAM-1 decreased more slowly due to the fact that the maximum positive effect of MSCs developed after 1 month. P-selectin, E-selectin, L-selectin, integrin - sVCAM-1 are the modern markers of inflammation and can be used to evaluate the effectiveness of biological therapy in IBD and the prognosis of the disease.
病理炎症过程的关键环节之一是黏附形成因子。它们在结肠黏膜炎症浸润的形成中起主导作用。生物疗法影响下黏附因子水平的变化尚未完全明确。鉴于此，我们研究的目的是调查生物疗法（英夫利昔单抗、间充质基质细胞）对炎症性肠病（IBD）患者黏附分子水平的影响。研究黏附分子在评估该组患者治疗效果中的作用。对30例IBD患者进行了检查。其中，16例为溃疡性结肠炎（UC）患者，14例为克罗恩病（CD）患者。其中，16例患者接受了5mg/kg体重的英夫利昔单抗治疗，14例IBD患者接受了引入间充质干细胞培养的综合抗炎治疗。在英夫利昔单抗治疗前后、间充质干细胞移植前后进行了临床血液检查、CRP检测，通过ELISA法测定血清中黏附分子L-选择素、E-选择素、P-选择素、整合素-sVCAM-1的水平。在英夫利昔单抗的影响下，所有IBD患者的P-选择素、E-选择素、整合素-sVCAM-1水平均显著降低。在间充质干细胞移植后的患者组中，P-选择素、E-选择素水平显著降低，整合素-sVCAM-1水平略有下降。间充质干细胞移植后及英夫利昔单抗治疗后的患者中L-选择素水平实际未降低，这反映了慢性自身免疫炎症，也是IBD长期使用生物疗法的依据。由于药物作用机制（抑制核心炎症细胞因子TNF-α的合成），IBD患者在英夫利昔单抗的影响下黏附分子P-选择素、E-选择素、整合素-sVCAM-1下降更快。间充质干细胞移植后，P-选择素、E-选择素、整合素-sVCAM-1下降更缓慢，因为间充质干细胞的最大积极作用在1个月后显现。P-选择素、E-选择素、L-选择素、整合素-sVCAM-1是现代炎症标志物，可用于评估IBD生物疗法的效果及疾病预后。
