Abou El Azm Abdel Raouf, Yousef Mohamed, Kobtan Abdelrahman, Awad Aymen, Elkassas Galal, Elfert Asem
Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Arab J Gastroenterol. 2015 Mar;16(1):20-4. doi: 10.1016/j.ajg.2015.02.005. Epub 2015 Mar 18.
Ulcerative colitis (UC) is a lifelong, chronic, progressive, and relapsing inflammatory disease. Endoscopy with biopsies is the mainstay in diagnosis and assessment. The development of biomarkers is important for the diagnosis and follow-up of UC. We investigated the expression of molecular chaperones/heat-shock proteins (HSP70 and HSP90) in relation to the grades of inflammation and dysplasia in patients with UC before and after treatment.
A total of 104 naïve patients with UC of varying severity were admitted to the Department of Tropical Medicine and Infectious Diseases, Tanta University Hospital. Ten biopsies from the healthy mucosa of patients with irritable bowel syndrome (IBS) served as a control. Disease activity was assessed clinically using the Mayo score system. Endoscopic mucosal biopsies were taken at diagnosis and 6 months after treatment. Histopathological activity was graded for inflammation and dysplasia. Immunohistochemistry was used to determine the percentage of cells positive for HSPs. The results were expressed in a semiquantitative scale.
The expression of both HSP70 and HSP90 increased in patients with UC at the time of disease activity, and it decreased after treatment and remission. There was a significant correlation between the expression of both proteins and the grades of dysplasia as well as inflammation (P < 0.05). Strong expression of HSPs that persisted after treatment has been associated with cases of true dysplasia.
The results indicated that HSP70 and HSP90 had the potential for assessment of the activity and prognosis of UC. They can also predict the presence of dysplasia and differentiate it from reactive atypia. Larger studies are needed to confirm this diagnostic and prognostic value of HSPs.
溃疡性结肠炎（UC）是一种终身性、慢性、进行性且复发性的炎症性疾病。内镜检查及活检是诊断和评估的主要手段。生物标志物的开发对于UC的诊断和随访至关重要。我们研究了分子伴侣/热休克蛋白（HSP70和HSP90）的表达与UC患者治疗前后炎症及发育异常分级的关系。
共有104例不同严重程度的初治UC患者入住坦塔大学医院热带医学与传染病科。取10例肠易激综合征（IBS）患者健康黏膜的活检组织作为对照。采用梅奥评分系统对疾病活动度进行临床评估。在诊断时及治疗后6个月进行内镜黏膜活检。对炎症和发育异常进行组织病理学活动度分级。采用免疫组织化学法测定HSPs阳性细胞的百分比。结果以半定量量表表示。
在疾病活动期，UC患者中HSP70和HSP90的表达均升高，治疗后缓解时表达降低。这两种蛋白的表达与发育异常及炎症分级之间存在显著相关性（P < 0.05）。治疗后持续存在的HSPs强表达与真正的发育异常病例相关。
结果表明，HSP70和HSP90具有评估UC活动度和预后的潜力。它们还可以预测发育异常的存在，并将其与反应性异型增生区分开来。需要更大规模的研究来证实HSPs的这种诊断和预后价值。
