评估嗜酸性粒细胞阳离子蛋白作为监测接受特殊排除饮食治疗的嗜酸性粒细胞性食管炎患者的生物标志物。
Assessing eosinophilic cationic protein as a biomarker for monitoring patients with eosinophilic esophagitis treated with specific exclusion diets.
作者信息
Doménech Witek Joan, Jover Cerdà Vicente, Gil Guillén Vicente, Doménech Clar Juan Bautista, Rodríguez Pacheco Ramón
机构信息
Hospital General de Elda, Sección de Alergología. H. Elda, Carretera de Sax, 03600 Elda, Alicante Spain.
Universidad Miguel Hernandez de Elche, Alicante, Spain.
出版信息
World Allergy Organ J. 2017 Mar 23;10(1):12. doi: 10.1186/s40413-017-0143-6. eCollection 2017.
BACKGROUND
Eosinophilic esophagitis (EoE) is a complex pathology. Attempts have been made in order to relate EoE with the intake of certain food. The problem is to establish which foods are really involved in the pathophysiology of this condition and to objectify a reliable inflammation biomarker for the follow-up of patients undergoing pharmacological treatment and/or diets. Our aim is to assess the food sensitization profile of patients with objective diagnosis of EoE and objectify the utility of ECP as an inflammation biomarker for the follow-up of patients with EoE treated with specific diets, based on the hypothesis that we will observe a decrease and clinical improvement after maintenance of these diets.
METHODS
A total of 19 subjects were included between 1 January 2012 and 30 June 2015. Diets based on allergy testing were established. Prior to the initiation of the diets, baseline ECP was determined. Appointments were arranged for the patients between 4 and 6 months later to assess the clinical response to the specific diets and to request a second blood sample for blood counts and serum ECP levels to compare with the previous baseline.
RESULTS
19 patients diagnosed with EoE (12 males and 7 females) between January 2012 and June 2015, aged between 17 and 68 (33.52; SD 13.67 years), were included consecutively, 15 of whom showed optimum response to specific diets based on allergy testing. A statistically significant difference ECP decrease was observed in our patients.
DISCUSSION
Until now most of the studies previously published in reference to the use of ECP as a biomarker for monitoring patients on treatment with diets show consistent but insignificant decreases in ECP levels. However, ECP seems to be a good marker of inflammation if the determinations are performed avoiding confounding factors.
CONCLUSION
The serial determination of ECP is useful when monitoring patients with EoE treated with specific diets.
背景
嗜酸性粒细胞性食管炎（EoE）是一种复杂的病理状况。人们已尝试将EoE与某些食物的摄入联系起来。问题在于确定哪些食物真正参与了该病症的病理生理过程，并确定一种可靠的炎症生物标志物，用于对接受药物治疗和/或饮食治疗的患者进行随访。我们的目的是评估客观诊断为EoE的患者的食物致敏情况，并确定嗜酸性粒细胞阳离子蛋白（ECP）作为炎症生物标志物在接受特定饮食治疗的EoE患者随访中的效用，基于这样的假设，即我们将观察到维持这些饮食后ECP水平下降且临床症状改善。
方法
在2012年1月1日至2015年6月30日期间共纳入19名受试者。建立了基于过敏测试的饮食方案。在开始饮食前，测定基线ECP。为患者安排4至6个月后的复诊，以评估对特定饮食的临床反应，并要求采集第二份血样进行血细胞计数和血清ECP水平检测，以便与之前的基线进行比较。
结果
2012年1月至2015年6月期间连续纳入19例诊断为EoE的患者（12例男性和7例女性），年龄在17至68岁之间（平均33.52岁；标准差13.67岁），其中15例对基于过敏测试的特定饮食表现出最佳反应。我们的患者中观察到ECP有统计学意义的下降。
讨论
到目前为止，之前发表的大多数关于使用ECP作为监测饮食治疗患者的生物标志物的研究显示，ECP水平虽有一致下降但不显著。然而，如果在测定时避免混杂因素，ECP似乎是一个良好的炎症标志物。
结论
连续测定ECP在监测接受特定饮食治疗的EoE患者时是有用的。
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