Voigtländer Torsten, Wlecke Jenny, Negm Ahmed A, Lenzen Henrike, Manns Michael P, Lankisch Tim O
*Department of Gastroenterology, Hepatology and Endocrinology †Integrated Research and Treatment Center-Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.
J Clin Gastroenterol. 2014 Nov-Dec;48(10):866-9. doi: 10.1097/MCG.0000000000000042.
Our aim was to evaluate the diagnostic potential of calprotectin in serum and bile of patients with primary sclerosing cholangitis (PSC).
PSC is a chronic cholestatic liver disease of unknown etiology. It is characterized by progressive inflammation and fibrosis of the bile ducts leading to biliary cirrhosis and eventually liver failure. Reliable markers for disease activity and severity are still lacking. Subunits of calprotectin, a fecal marker of inflammation in inflammatory bowel disease, have been recently identified in bile.
Calprotectin was measured in patients with PSC (n=56), cholangiocarcinoma (CC) complicating PSC (CC/PSC) (n=13), CC (n=30), and bile duct stones in bile (n=38) and serum (n=73) by enzyme-linked immunosorbent assay in a cross-sectional study. PSC patients were categorized by the Mayo risk score (MRS) to characterize the disease severity.
Calprotectin is present in bile, and the median concentration was significantly higher in PSC patients (P<0.05). Stratification of PSC patients by MRS showed significantly elevated calprotectin levels in bile in the MRS-high group (P<0.05). Calprotectin and MRS correlated significantly (P<0.05). The presence or absence of inflammatory bowel disease in PSC patients did not alter calprotectin levels in bile. Serum AP and calprotectin in bile correlated significantly (P=0.013). No significant correlation was found for other liver-related parameters. In contrast, serum calprotectin levels were significantly higher in patients with CC, but there was no association with PSC or disease activity/severity.
Calprotectin in bile is a promising disease marker in patients with PSC with a potential prognostic value.
我们的目的是评估钙卫蛋白在原发性硬化性胆管炎（PSC）患者血清和胆汁中的诊断潜力。
PSC是一种病因不明的慢性胆汁淤积性肝病。其特征是胆管进行性炎症和纤维化，导致胆汁性肝硬化并最终发展为肝衰竭。目前仍缺乏用于评估疾病活动度和严重程度的可靠标志物。钙卫蛋白是炎症性肠病的一种粪便炎症标志物，其亚单位最近在胆汁中被发现。
在一项横断面研究中，通过酶联免疫吸附测定法对PSC患者（n = 56）、并发PSC的胆管癌（CC/PSC）患者（n = 13）、CC患者（n = 30）以及胆汁（n = 38）和血清（n = 73）中有胆管结石的患者进行钙卫蛋白检测。根据梅奥风险评分（MRS）对PSC患者进行分类，以表征疾病严重程度。
钙卫蛋白存在于胆汁中，PSC患者胆汁中钙卫蛋白的中位数浓度显著更高（P<0.05）。根据MRS对PSC患者进行分层显示，MRS高分组患者胆汁中的钙卫蛋白水平显著升高（P<0.05）。钙卫蛋白与MRS显著相关（P<0.05）。PSC患者是否存在炎症性肠病并不影响胆汁中钙卫蛋白的水平。胆汁中的血清碱性磷酸酶（AP）与钙卫蛋白显著相关（P = 0.013）。未发现其他肝脏相关参数之间存在显著相关性。相比之下，CC患者血清中的钙卫蛋白水平显著更高，但与PSC或疾病活动度/严重程度无关。
胆汁中的钙卫蛋白是PSC患者中一种有前景的疾病标志物，具有潜在的预后价值。
