Tursi Antonio, Elisei Walter, Principi Mariabeatrice, Inchingolo Cosimo Damiano, Nenna Rosanna, Picchio Marcello, Giorgio Floriana, Ierardi Enzo, Brandimarte Giovanni
Gastroenterology Service, ASL BAT, Andria (BT), Italy.
Division of Gastroenterology, ASL Roma H, Albano Laziale (Roma), Italy.
J Gastrointestin Liver Dis. 2014 Sep;23(3):261-5. doi: 10.15403/jgld.2014.1121.233.we2.
BACKGROUND AND AIMS: Both inflammation and fibrosis may be detected in Crohn's disease (CD). The molecular pattern of Basic Fibroblastic Growth Factor (bFGF) and Syndecan-1 (SD1) expression is altered in stenosing CD, but we do not know what the behaviour of this teamwork factor is in CD in deep remission under treatment with anti-TNFα antibodies. Our aim was to compare the expression of bFGF, SD1 and TNF-α in patients with CD in deep remission under treatment with Infliximab (IFX) or Adalimumab (ADA) and a control group of patients with active CD. METHODS: We assessed the expression of bFGF, SD1 and TNF-α in 10 patients with active CD and in 28 patients with CD in sustained deep remission for at least 6 months. All patients underwent surveillance colonoscopy with biopsies, while receiving maintenance therapy with IFX or ADA. Analysis was conducted by real-time reverse transcriptase PCR (RT-PCR) in biopsy samples. RESULTS: We found that bFGF, SD1 and TNF-α were significantly reduced under treatment with anti-TNFα versus controls (p=0.000). bFGF and SD1 expression were similar between IFX and ADA patients (p=0.335 and p=0.289, respectively), while TNF-α was significantly under-expressed in ADA patients (p=0.008). CONCLUSIONS: bFGF, SD1 and TNF-α are significantly reduced in CD patients in deep remission under treatment with anti-TNFα, likely as an expression of optimal control of inflammation. The significance of the TNF-α under-expression in patients under treatment with ADA with respect to those under treatment with IFX should be elucidated in further studies.
背景与目的:炎症和纤维化在克罗恩病(CD)中均可被检测到。在狭窄型CD中,碱性成纤维细胞生长因子(bFGF)和Syndecan-1(SD1)的分子表达模式发生改变,但我们尚不清楚在接受抗TNFα抗体治疗处于深度缓解期的CD中,这种协同作用因子的表现如何。我们的目的是比较接受英夫利昔单抗(IFX)或阿达木单抗(ADA)治疗处于深度缓解期的CD患者与活动性CD患者对照组中bFGF、SD1和TNF-α的表达情况。 方法:我们评估了10例活动性CD患者和28例持续深度缓解至少6个月的CD患者中bFGF、SD1和TNF-α的表达。所有患者在接受IFX或ADA维持治疗时均接受监测结肠镜检查及活检。通过实时逆转录聚合酶链反应(RT-PCR)对活检样本进行分析。 结果:我们发现,与对照组相比,抗TNFα治疗组中bFGF、SD1和TNF-α显著降低(p = 0.000)。IFX组和ADA组患者的bFGF和SD1表达相似(分别为p = 0.335和p = 0.289),而ADA组患者的TNF-α表达显著降低(p = 0.008)。 结论:接受抗TNFα治疗的深度缓解期CD患者中,bFGF、SD1和TNF-α显著降低,这可能是炎症得到最佳控制的一种表现。ADA治疗患者与IFX治疗患者相比,TNF-α表达降低的意义有待进一步研究阐明。
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