粪便高迁移率族蛋白B1揭示临床及内镜检查缓解期的成人和儿童炎症性肠病患者存在微观炎症
Fecal HMGB1 Reveals Microscopic Inflammation in Adult and Pediatric Patients with Inflammatory Bowel Disease in Clinical and Endoscopic Remission.
作者信息
Palone Francesca, Vitali Roberta, Cucchiara Salvatore, Mennini Maurizio, Armuzzi Alessandro, Pugliese Daniela, DʼIncà Renata, Barberio Brigida, Stronati Laura
机构信息
*Department of Radiation Biology and Human Health, ENEA, Rome, Italy; †Department of Pediatrics and Infantile Neuropsychiatry, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy; ‡Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Gemelli Hospital Catholic University Foundation, Rome, Italy; §Department of Surgical, Oncological and Gastroenterological Sciences, Azienda Ospedaliera-Università degli Studi di Padova, Padova, Italy; and ‖Department of Cellular Biotechnology and Hematology, Sapienza University of Rome, Rome, Italy.
出版信息
Inflamm Bowel Dis. 2016 Dec;22(12):2886-2893. doi: 10.1097/MIB.0000000000000938.
BACKGROUND
Fecal high mobility group box 1 (HMGB1) has been suggested to be a novel noninvasive biomarker of gut inflammation. We aimed to assess the reliability of fecal HMGB1, compared with fecal calprotectin (FC), in detecting intestinal inflammation in pediatric and adult patients with inflammatory bowel disease (IBD) and to evaluate the accuracy of HMGB1 in identifying patients with IBD in clinical and endoscopic remission who still have histologic features of inflammation.
METHODS
Stool samples from 85 children with IBD (49 Crohn's disease [CD] and 36 ulcerative colitis [UC] and 119 adults [57 Crohn's disease and 62 ulcerative colitis]) were analyzed for the study. Age-matched healthy subjects were used as controls. Fecal HMGB1 and fecal calprotectin were detected through western blot and ELISA, respectively.
RESULTS
Fecal HMGB1 expression was significantly increased in pediatric and adult patients with Crohn's disease and ulcerative colitis and strongly correlated with the disease severity. Fecal calprotectin and HMGB1 significantly correlated in pediatric (r: 0.60, P < 0.001) and adult (r: 0.72, P < 0.001) IBD patients. Moreover, in patients with clinical and endoscopic remission only fecal HMGB1 showed a strong match with the degree of histological scores of inflammation (CGHAS/IGHAS for Crohn's disease and Geboes Score for ulcerative colitis).
CONCLUSIONS
Fecal HMGB1 is confirmed to be a reliable biomarker of intestinal inflammation; indeed, it significantly correlates with fecal calprotectin in pediatric and adult IBD patients. Moreover, only fecal HMGB1 identifies histologic inflammation in subjects with IBD in clinical and endoscopic remission.
背景
粪便高迁移率族蛋白B1（HMGB1）已被认为是肠道炎症的一种新型非侵入性生物标志物。我们旨在评估与粪便钙卫蛋白（FC）相比，粪便HMGB1在检测儿童和成人炎症性肠病（IBD）患者肠道炎症方面的可靠性，并评估HMGB1在识别临床和内镜缓解但仍具有炎症组织学特征的IBD患者中的准确性。
方法
本研究分析了85例IBD儿童（49例克罗恩病[CD]和36例溃疡性结肠炎[UC]）以及119例成人（57例克罗恩病和62例溃疡性结肠炎）的粪便样本。年龄匹配的健康受试者作为对照。分别通过蛋白质印迹法和酶联免疫吸附测定法检测粪便HMGB1和粪便钙卫蛋白。
结果
儿童和成人克罗恩病及溃疡性结肠炎患者的粪便HMGB1表达显著增加，且与疾病严重程度密切相关。粪便钙卫蛋白和HMGB1在儿童（r：0.60，P<0.001）和成人（r：0.72，P<0.001）IBD患者中显著相关。此外，在临床和内镜缓解的患者中，仅粪便HMGB1与炎症组织学评分程度（克罗恩病的CGHAS/IGHAS和溃疡性结肠炎的Geboes评分）有很强的匹配度。
结论
粪便HMGB1被证实是肠道炎症的可靠生物标志物；事实上，它在儿童和成人IBD患者中与粪便钙卫蛋白显著相关。此外，只有粪便HMGB1能识别临床和内镜缓解的IBD患者中的组织学炎症。
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