Hagiwara Shin-Ichiro, Okayasu Isao, Fujiwara Mutsunori, Matsuura Masaaki, Ohnishi Hiromitsu, Ito Satoru, Kishimoto Hiroshi, Nambu Ryusuke, Kagimoto Seiichi
*Division of General Pediatrics, Saitama Children's Medical Center †Department of Pathology, Kitasato University School of Medicine ‡Department of Clinical Pathology, Japanese Red Cross Medical Center §Teikyo University Graduate School of Public Health ||Healthtec, Inc ¶IDAC Theranostics, Inc #Division of Pathology, Saitama Children's Medical Center.
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):955-961. doi: 10.1097/MPG.0000000000001477.
Prostaglandin E-major urinary metabolite (PGE-MUM) is a useful biomarker for adult ulcerative colitis (UC) activity. In the present study, we evaluated whether PGE-MUM can also be a biomarker of pediatric UC activity and compared its efficacy in predicting UC activity with that of C-reactive protein and erythrocyte sedimentation rate.
Twenty-nine pediatric patients with UC (8-18 years) and 29 healthy age- and sex-matched subjects were enrolled. UC activity was evaluated using the Pediatric Ulcerative Colitis Activity Index, highest Mayo endoscopic scoring (Mayo), and Matts grading (Matts) for histologic scoring, and the sum of Mayo (total of 6 segments) and Matts in all patients with UC. PGE-MUM levels were measured using a radioimmunoassay.
PGE-MUM levels were elevated in endoscopically and histologically active UC patients, but not in patients with endoscopic and histologic remission or controls. PGE-MUM levels positively and significantly correlated with UC activity. PGE-MUM levels were positively correlated with Pediatric Ulcerative Colitis Activity Index (r = 0.594), highest Mayo (r = 0.462), the sum of Mayo (r = 0.694), and the sum of Matts (r = 0.613), but not with highest Matt (r = 0.352). The sum of Mayo and the sum of Matts, which reflect total colon inflammation, showed highest correlation with PGE-MUM. C-reactive protein levels did not correlate with any UC activity scores. Erythrocyte sedimentation rate exhibited correlation (r = 0.490) with the sum of Mayo only.
PGE-MUM is a reliable biomarker that reflects both the endoscopic and histologic activity of the entire colon in pediatric UC.
前列腺素E主要尿代谢物（PGE-MUM）是成人溃疡性结肠炎（UC）活动的一种有用生物标志物。在本研究中，我们评估了PGE-MUM是否也可作为儿童UC活动的生物标志物，并将其预测UC活动的效能与C反应蛋白和红细胞沉降率进行比较。
纳入29例8至18岁的儿童UC患者以及29名年龄和性别匹配的健康受试者。使用儿童溃疡性结肠炎活动指数、最高梅奥内镜评分（梅奥）和用于组织学评分的马茨分级（马茨）评估UC活动，并计算所有UC患者的梅奥总分（共6个节段）和马茨总分。采用放射免疫分析法测量PGE-MUM水平。
内镜和组织学活动期的UC患者PGE-MUM水平升高，但内镜和组织学缓解的患者及对照组未升高。PGE-MUM水平与UC活动呈正相关且具有显著性。PGE-MUM水平与儿童溃疡性结肠炎活动指数（r = 0.594）、最高梅奥评分（r = 0.462）、梅奥总分（r = 0.694）和马茨总分（r = 0.613）呈正相关，但与最高马茨评分（r = 0.352）无相关性。反映全结肠炎症的梅奥总分和马茨总分与PGE-MUM的相关性最高。C反应蛋白水平与任何UC活动评分均无相关性。红细胞沉降率仅与梅奥总分呈相关性（r = 0.490）。
PGE-MUM是一种可靠的生物标志物，可反映儿童UC全结肠的内镜和组织学活动情况。
