炎症性肠病的炎症生物标志物。

Biomarkers of Inflammation in Inflammatory Bowel Disease.

机构信息

Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

Gastroenterology. 2015 Oct;149(5):1275-1285.e2. doi: 10.1053/j.gastro.2015.07.003. Epub 2015 Jul 9.

Abstract

Recent observations suggest that subjective measures of disease activity in inflammatory bowel disease (IBD) are often misleading. Objective measures of inflammation are more closely associated with important long-term outcomes, but often depend upon invasive and costly procedures such as ileocolonoscopy and cross-sectional imaging by computed tomography or magnetic resonance imaging. Noninvasive, accurate, and inexpensive measures of intestinal inflammation would allow clinicians to adopt widely the paradigm of adjusting therapies with a goal of controlling inflammation. Blood, stool, and urine markers have all been explored as indicators of intestinal inflammation in IBD, and although none has been universally adopted, some have been well-characterized, and others hold great promise. Serum C-reactive protein and fecal calprotectin are among the best-studied noninvasive biomarkers of inflammation in IBD, and their test characteristics have been described in the setting of differentiating IBD from irritable bowel syndrome, for grading inflammation, to describe the response to therapy, and in demonstrating recurrent inflammation after medical or surgically induced remission. High-throughput research platforms, including gene expression arrays, metabolomics and proteomics, are also being applied to the discovery of novel biomarkers of inflammation. It is certain that biomarkers of inflammation will attain growing importance in the clinic as we strive for more effective and cost-effective strategies to treat patients with IBD.

摘要

最近的观察结果表明,炎症性肠病(IBD)患者的主观疾病活动度评估往往具有误导性。炎症的客观指标与重要的长期预后更为密切相关,但通常依赖于侵入性和昂贵的程序,如回结肠镜检查和计算机断层扫描或磁共振成像的横断面成像。非侵入性、准确和廉价的肠道炎症测量方法将使临床医生能够广泛采用调整治疗以控制炎症的范式。血液、粪便和尿液标志物都被探索作为 IBD 肠道炎症的指标,虽然没有一种标志物被普遍采用,但有些标志物已经得到了很好的描述,而其他标志物则具有很大的前景。血清 C 反应蛋白和粪便钙卫蛋白是研究最多的 IBD 炎症的非侵入性生物标志物之一,它们的检测特征已经在区分 IBD 与肠易激综合征、评估炎症程度、描述治疗反应以及在药物或手术诱导缓解后显示复发炎症方面得到了描述。高通量研究平台,包括基因表达谱、代谢组学和蛋白质组学,也被应用于炎症新型生物标志物的发现。随着我们努力寻求更有效和更具成本效益的治疗 IBD 患者的策略,炎症标志物在临床上的重要性肯定会越来越大。

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