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Elafin 在炎症性肠病中的表达及临床意义。

Expression and Clinical Significance of Elafin in Inflammatory Bowel Disease.

机构信息

Department of Gastroenterology, Peking University First Hospital, Beijing, China.

出版信息

Inflamm Bowel Dis. 2017 Dec;23(12):2134-2141. doi: 10.1097/MIB.0000000000001252.

Abstract

BACKGROUND

The expression of elafin in inflammatory bowel disease (IBD) is controversial. Here, we detected the expression of elafin in the peripheral blood and colonic mucosa of patient with IBD and then explored its role and value in assessing the activity and severity of IBD.

MATERIALS AND METHODS

Sixty-eight patients with IBD were selected as an experimental group. The control group included 38 healthy individuals. The expression of elafin mRNA in peripheral blood leukocytes and in serum was detected by qRT-PCR and enzyme-linked immunosorbent assay, respectively. The inflamed and noninflamed tissues were collected by colonoscopy. The expression of elafin in the intestinal mucosa was determined by immunohistochemistry staining and qRT-PCR. The expression of elafin between groups and among each stage of IBD was compared. The correlations of elafin expression with erythrocyte sedimentation rate and C-reactive protein were determined by Spearman's correlation analysis and with clinical disease activity indices (Best Crohn's Disease Activity Index and modified Mayo scores) by Pearson's correlation analysis.

RESULTS

Elafin mRNA levels decreased significantly in active ulcerative colitis (UC) but increased in remission UC. However, in Crohn's disease (CD), we did not detect the aforementioned significant differences. Although serum IL-8 levels increased, serum elafin concentrations decreased both in UC and in CD, but the differences among stages were not significant. The expression of elafin in the inflamed colonic mucosa in both CD and UC was lower than that in the normal mucosa in controls and lower than that in the noninflamed mucosa in IBD. Moreover, the relative expression of elafin mRNA in peripheral blood leukocytes in UC was negatively correlated with erythrocyte sedimentation rate, C-reactive protein, and modified Mayo scores, and in CD, it was negatively correlated with Best Crohn's Disease Activity Index scores.

CONCLUSIONS

Elafin decreased in active patients with IBD and was negatively correlated with disease activity, suggesting that elafin may play a protective role and could be used as an index to evaluate disease activity in IBD.

摘要

背景

弹性蛋白酶抑制剂(elafin)在炎症性肠病(IBD)中的表达存在争议。本研究检测了 IBD 患者外周血和结肠黏膜中 elafin 的表达,并探讨其在评估 IBD 活动度和严重程度中的作用和价值。

材料和方法

选择 68 例 IBD 患者作为实验组,另选 38 例健康个体作为对照组。采用 qRT-PCR 和酶联免疫吸附试验分别检测外周血白细胞和血清中 elafin mRNA 的表达,通过结肠镜采集病变和非病变组织,免疫组化染色和 qRT-PCR 检测肠黏膜中 elafin 的表达。比较各组及各期 IBD 间 elafin 的表达差异,采用 Spearman 相关分析评估 elafin 表达与红细胞沉降率和 C 反应蛋白的相关性,采用 Pearson 相关分析评估 elafin 表达与临床疾病活动指数(最佳克罗恩病活动指数和改良 Mayo 评分)的相关性。

结果

活动期溃疡性结肠炎(UC)患者 elafin mRNA 水平显著降低,缓解期 UC 患者则升高,而克罗恩病(CD)患者未检测到上述显著差异。虽然血清 IL-8 水平升高,但 UC 和 CD 患者血清 elafin 浓度均降低,但各期之间差异无统计学意义。CD 和 UC 患者炎症性结肠黏膜中 elafin 的表达均低于对照组正常黏膜,也低于 IBD 患者非炎症性黏膜。此外,UC 患者外周血白细胞中 elafin mRNA 的相对表达与红细胞沉降率、C 反应蛋白和改良 Mayo 评分呈负相关,CD 患者则与最佳克罗恩病活动指数评分呈负相关。

结论

活动期 IBD 患者 elafin 表达降低,与疾病活动度呈负相关,提示 elafin 可能发挥保护作用,可作为评估 IBD 疾病活动度的指标。

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