Erdem Emrullah, Kochan Koray, Paker Nurcan, Gokden Yasemin, Degirmenci Ayca Salturk, Kocak Fatin, Gonen Can
Haydarapasa Numune Training and Research Hospital, Istanbul, Turkey.
Duzen Laboratory, Istanbul, Turkey.
North Clin Istanb. 2015 Jan 24;1(3):127-131. doi: 10.14744/nci.2014.13008. eCollection 2014.
A strong correlation exists between tenascin-C induction, and acute inflammation. Generally increased tenascin-C concentrations are correlated with various inflammatory, and infectious diseases. In patients with diagnosis of Inflammatory Bowel Disease (IBD) presence of tenascin-C in colonic mucosa demonstrates tissue repair, and its mucosal concentrations are correlated with local disease activity Therefore plasma levels of tenascin-C have been demonstrated to be a helpful indicator of the activity of inflammatory bowel diseases. In this study, firstly in the literature, we aimed to display the correlation between tenascin-C expression, and formation of intestinal stricture.
A total of 43 patients (male, n=19; 44.2%; and female, n=24, 55.8%) aged between 19, and 63 years, with clinically, endoscopically, radiologically, and histopathologically confirmed definitive diagnosis of Crohn's disease who were examined, diagnosed, and treated in the Gastroenterology Clinic of Haydarpasa Numune Training and Research Hospital between January 2011, and April 2012 were investigated. Serum tenascin-C levels were measured using commercial sandwich enzyme-linked immunosorbent assay Human Tenascin-C Purified Protein kit (Chemicon, Millipore(R), USA). Study groups were categorized based on the type of the disease as inflammatory (n=17; 39.5%), obstructive (27.2%), and fistule formation (n=10; 23.3%) Crohn's disease. For statistical analysis SPSS (Statistical Package for Social Sciences) Statistics 15 program was used.
Median tenascin- C value in the obstructive group (6.57 ng/mL; range, 4.26-21.87 ng/mL) was statistically significantly higher than that detected in the inflammatory (1.74 ng/mL; range,1.29-3.16 ng/mL), and fistulizing (1.44 ng/mL; range, 0.74-2.47 ng/mL) groups (p=0.002).
Intestinal fibroblasts have an important role in the stricture formation process in CD. Transforming growth factor (TGF)-b1 cytokine is in the center of this process. A strong correlation exists between tenascin-C induction, and acute inflammation. As a known fact, serum tenascin-C levels can be used in the determination of activity of IBD. Starting from this point, serum tenascin-C levels can be useful in the categorization of the Crohn's disease without the need for invasive methods. In the future, studies with larger patient series investigating use of serum tenascin-C in the prediction of stricturing Crohn's disease should be conducted.
肌腱蛋白-C的诱导与急性炎症之间存在密切关联。一般来说，肌腱蛋白-C浓度升高与各种炎症和感染性疾病相关。在诊断为炎症性肠病（IBD）的患者中，结肠黏膜中肌腱蛋白-C的存在表明组织修复，其黏膜浓度与局部疾病活动相关。因此，已证明肌腱蛋白-C的血浆水平是炎症性肠病活动的一个有用指标。在本研究中，我们首次旨在揭示肌腱蛋白-C表达与肠道狭窄形成之间的相关性。
对2011年1月至2012年4月在海达尔帕萨努穆内培训和研究医院胃肠病科接受检查、诊断和治疗的43例患者（男性19例，占44.2%；女性24例，占55.8%）进行调查，这些患者年龄在19至63岁之间，临床、内镜、放射和组织病理学检查均确诊为克罗恩病。使用商业夹心酶联免疫吸附测定人肌腱蛋白-C纯化蛋白试剂盒（Chemicon，Millipore(R)，美国）测量血清肌腱蛋白-C水平。研究组根据疾病类型分为炎症性（n=17；39.5%）、梗阻性（27.2%）和瘘管形成性（n=10；23.3%）克罗恩病。采用SPSS（社会科学统计软件包）Statistics 15程序进行统计分析。
梗阻组肌腱蛋白-C的中位数（6.57 ng/mL；范围4.26 - 21.87 ng/mL）在统计学上显著高于炎症组（1.74 ng/mL；范围1.29 - 3.16 ng/mL）和瘘管形成组（1.44 ng/mL；范围0.74 - 2.47 ng/mL）（p=0.002）。
肠道成纤维细胞在克罗恩病的狭窄形成过程中起重要作用。转化生长因子（TGF）-β1细胞因子处于这一过程的核心。肌腱蛋白-C的诱导与急性炎症之间存在密切关联。众所周知，血清肌腱蛋白-C水平可用于确定IBD的活动情况。基于此，血清肌腱蛋白-C水平可用于克罗恩病的分类，而无需采用侵入性方法。未来，应开展更大规模患者系列研究，探讨血清肌腱蛋白-C在预测狭窄性克罗恩病中的应用。
