Pawlica-Gosiewska Dorota, Solnica Bogdan, Gawlik Katarzyna, Cibor Dorota, Mach Tomasz, Fedak Danuta, Owczarek Danuta
Department of Diagnostics, Chair of Clinical Biochemistry Jagiellonian University Medical College Krakow, Poland.
Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Krakow, Poland.
Postepy Hig Med Dosw (Online). 2017 Apr 6;71(0):243-253. doi: 10.5604/01.3001.0010.3810.
Difficulties in diagnosis of inflammatory bowel disease (IBD) motivate the search for new diagnostic tools, including laboratory tests. The aim of this study was to evaluate concentrations of the neutrophil (NEU) proteins leukocyte elastase (HLE-α1AT), lactoferrin and calprotectin as potential biomarkers used in the diagnosis and assessment of clinical activity of Crohn's disease (CD) and ulcerative colitis (UC).
MATERIAL/METHODS: The study included 27 patients with CD, 33 patients with UC and 20 healthy controls. Plasma concentrations of calprotectin, lactoferrin and HLE-α1AT were measured using ELISA.
In patients with CD higher concentrations of HLE-α1AT (64.3±43.1 vs. 30.1±7.7 ng/l, P<0.001), calprotectin (151.6±97.8 vs. 69.9±22.1 ng/l, P<0.001) and lactoferrin (243.2±102.0 vs. 129.7±32.7 ng/l, P<0.001) than in the control group were found. In patients with UC higher plasma concentrations of HLE-α1AT (62.0±30.9 vs. 30.1±7.7 ng/l, P<0.001), calprotectin (149.6±72.3 vs. 69.9±22.1 ng/l, P<0.001) and lactoferrin (242.6±107.5 vs 129.7±32.7 ng/l, P<0.001) than in the control group were found. HLE-α1AT/NEU and lactoferrin/NEU ratios in patients with UC were significantly higher compared with patients with CD. Calprotectin (P=0.010) and lactoferrin (P=0.023) levels were higher in patients with the active compared with inactive phase of CD.
The diagnostic characteristics of plasma granulocyte protein concentrations indicate the usefulness of these tests in the diagnosis of IBD. Higher HLE-α1AT and lactoferrin/NEU ratios in patients with UC than with CD may suggest the usefulness of these ratios in differential diagnostics. Plasma calprotectin and lactoferrin levels may be useful in CD activity assessment.
炎症性肠病（IBD）的诊断困难促使人们寻找新的诊断工具，包括实验室检测。本研究的目的是评估中性粒细胞（NEU）蛋白白细胞弹性蛋白酶（HLE-α1AT）、乳铁蛋白和钙卫蛋白的浓度，作为用于诊断和评估克罗恩病（CD）和溃疡性结肠炎（UC）临床活动度的潜在生物标志物。
材料/方法：本研究纳入了27例CD患者、33例UC患者和20名健康对照者。采用酶联免疫吸附测定法（ELISA）测量血浆中钙卫蛋白、乳铁蛋白和HLE-α1AT的浓度。
发现CD患者的HLE-α1AT浓度（64.3±43.1 vs. 30.1±7.7 ng/l，P<0.001）、钙卫蛋白浓度（151.6±97.8 vs. 69.9±22.1 ng/l，P<0.001）和乳铁蛋白浓度（243.2±102.0 vs. 129.7±32.7 ng/l，P<0.001）均高于对照组。UC患者的血浆HLE-α1AT浓度（62.0±30.9 vs. 30.1±7.7 ng/l，P<0.001）、钙卫蛋白浓度（149.6±72.3 vs. 69.9±22.1 ng/l，P<0.001）和乳铁蛋白浓度（242.6±107.5 vs 129.7±32.7 ng/l，P<0.001）也高于对照组。UC患者的HLE-α1AT/NEU和乳铁蛋白/NEU比值显著高于CD患者。CD活动期患者与非活动期患者相比，钙卫蛋白水平（P=0.010）和乳铁蛋白水平（P=0.023）更高。
血浆粒细胞蛋白浓度的诊断特征表明这些检测在IBD诊断中的有用性。UC患者的HLE-α1AT和乳铁蛋白/NEU比值高于CD患者，这可能提示这些比值在鉴别诊断中的有用性。血浆钙卫蛋白和乳铁蛋白水平可能有助于评估CD的活动度。
