Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Crohns Colitis. 2018 Jan 5;12(1):87-95. doi: 10.1093/ecco-jcc/jjx124.
Novel noninvasive biomarkers with high diagnostic accuracy are required to assess mucosal healing, which is associated with sustained clinical remission, in inflammatory bowel disease. This study aimed to explore sepsis markers as potential biomarkers for mucosal healing.
Patients with ulcerative colitis [UC] or Crohn's disease [CD], who underwent blood tests for C-reactive protein [CRP], serum procalcitonin [PCT], soluble interleukin-2 receptor [sIL-2R], and plasma soluble CD14 subtype [sCD14-ST] within 2 weeks of endoscopy, were retrospectively recruited; and we assessed the relationship between marker levels and clinical features. Complete mucosal healing [cMH] was defined as a Mayo endoscopic subscore [MES] of 0 for UC and a simple endoscopic score for Crohn's disease [SES-CD] of 0 for CD.
In all, 68 UC patients and 33 CD patients were included in this study. In patients with UC, the sIL-2R level was significantly higher in patients without cMH than in those with cMH. The sIL-2R level had the highest diagnostic value for identifying cMH in UC. In patients with CD, CRP and sCD14-ST levels were significantly higher in patients without cMH than in those with cMH, and both CRP and sCD14-ST had good diagnostic values for identifying cMH. The sCD14-ST level had a high diagnostic value for identifying cMH even among CD patients with complete clinical remission, defined as a Harvey-Bradshaw index of 0.
The sIL-2R and sCD14-ST levels in patients with UC and CD, respectively, can be useful surrogate markers for identifying mucosal healing in inflammatory bowel disease.
需要新型非侵入性生物标志物,具有较高的诊断准确性,以评估黏膜愈合,这与炎症性肠病的持续临床缓解相关。本研究旨在探索脓毒症标志物作为黏膜愈合的潜在生物标志物。
回顾性招募了溃疡性结肠炎[UC]或克罗恩病[CD]患者,这些患者在内镜检查前 2 周内进行了 C 反应蛋白[CRP]、血清降钙素原[PCT]、可溶性白细胞介素-2 受体[sIL-2R]和血浆可溶性 CD14 亚型[sCD14-ST]的血液检查;并评估了标志物水平与临床特征之间的关系。完全黏膜愈合[cMH]定义为 UC 的 Mayo 内镜亚评分[MES]为 0 和 CD 的简单内镜评分[SES-CD]为 0。
本研究共纳入 68 例 UC 患者和 33 例 CD 患者。在 UC 患者中,无 cMH 患者的 sIL-2R 水平明显高于有 cMH 患者。sIL-2R 水平对识别 UC 中的 cMH 具有最高的诊断价值。在 CD 患者中,无 cMH 患者的 CRP 和 sCD14-ST 水平明显高于有 cMH 患者,CRP 和 sCD14-ST 对识别 cMH 均具有良好的诊断价值。即使在定义为 Harvey-Bradshaw 指数为 0 的完全临床缓解的 CD 患者中,sCD14-ST 水平对识别 cMH 也具有较高的诊断价值。
UC 和 CD 患者的 sIL-2R 和 sCD14-ST 水平分别可以作为识别炎症性肠病黏膜愈合的有用替代标志物。