Łykowska-Szuber Liliana, Klimczak Katarzyna, Eder Piotr, Krela-Kaźmierczak Iwona, Stawczyk-Eder Kamila, Michalak Michał, Studniarek Adam, Kościński Tomasz, Szymczak Aleksandra, Linke Krzysztof
Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland.
Prz Gastroenterol. 2016;11(4):232-238. doi: 10.5114/pg.2015.55700. Epub 2015 Nov 23.
Monitoring the response to biological treatment in Crohn's disease (CD) is a very important element of the therapeutic optimisation.
To evaluate the usefulness of measuring calprotectin, lactoferrin, and myeloperoxidase in stool as markers of long-term clinical and endoscopic response to anti-tumour necrosis factor α (anti-TNF) treatment in CD.
The studied group consisted of 35 CD patients treated with anti-TNF-α antibodies. Clinical activity was evaluated using Crohn's Disease Activity Index (CDAI), and the exacerbation of endoscopic changes was evaluated using a Simple Endoscopic Score for Crohn's Disease (SES-CD). The concentration of calprotectin, lactoferrin, and myeloperoxidase was measured using the ELISA method. All measurements were performed three times - before, after 3 months, and after a year of therapy.
During anti-TNF treatment the concentrations of all measured faecal markers decreased significantly in relation to baseline values. We observed a significant correlation at all time-points: before the therapy, after 3 months, and 12 months after starting the therapy, between the concentration of calprotectin and SES-CD, calprotectin and CDAI, as well as between lactoferrin and SES-CD, and lactoferrin and CDAI. Myeloperoxidase correlated with both SES-CD and CDAI only after 1 year of treatment.
Faecal calprotectin and lactoferrin are valuable markers of clinical and endoscopic activity of CD in patients treated with anti-TNF antibodies. They are useful in monitoring the response to treatment. The usefulness of myeloperoxidase in this respect remains controversial.
监测克罗恩病（CD）对生物治疗的反应是优化治疗的一个非常重要的因素。
评估检测粪便中钙卫蛋白、乳铁蛋白和髓过氧化物酶作为CD患者长期临床和内镜对抗肿瘤坏死因子α（抗TNF）治疗反应标志物的有用性。
研究组由35例接受抗TNF-α抗体治疗的CD患者组成。使用克罗恩病活动指数（CDAI）评估临床活动度，使用克罗恩病简单内镜评分（SES-CD）评估内镜改变的加重情况。采用ELISA法检测钙卫蛋白、乳铁蛋白和髓过氧化物酶的浓度。所有测量均进行三次——治疗前、治疗3个月后和治疗1年后。
在抗TNF治疗期间，所有检测的粪便标志物浓度相对于基线值均显著下降。我们在所有时间点均观察到显著相关性：治疗前、治疗3个月后和开始治疗12个月后，钙卫蛋白浓度与SES-CD、钙卫蛋白与CDAI之间，以及乳铁蛋白与SES-CD、乳铁蛋白与CDAI之间均存在显著相关性。仅在治疗1年后，髓过氧化物酶与SES-CD和CDAI均相关。
粪便钙卫蛋白和乳铁蛋白是接受抗TNF抗体治疗的CD患者临床和内镜活动的有价值标志物。它们有助于监测治疗反应。髓过氧化物酶在这方面的有用性仍存在争议。
