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粪便钙卫蛋白能否预测炎症性肠病复发:一篇综述

Can faecal calprotectin predict relapse in inflammatory bowel disease: a mini review.

作者信息

Chew T S, Mansfield J C

机构信息

Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

出版信息

Frontline Gastroenterol. 2018 Jan;9(1):23-28. doi: 10.1136/flgastro-2016-100686. Epub 2016 Apr 5.

Abstract

Crohn's disease and ulcerative colitis are chronic inflammatory disorders affecting the gastrointestinal tract. Faecal calprotectin is a protein complex of the S-100 family of calcium-binding proteins present in inflammatory cells that can be measured in stool samples, which act as a biomarker for bowel inflammation. Elevated faecal calprotectin has been shown to reflect the presence of ongoing mucosal inflammation, which improves with mucosal healing. The aim of this review was to evaluate the available evidence on the ability of faecal calprotectin to predict a relapse in inflammatory bowel disease. Multiple retrospective studies have shown that patients who relapse have significantly higher levels of calprotectin in their stool compared with non-relapsers, especially in ulcerative colitis. Elevated faecal calprotectin postoperatively in Crohn's disease was also shown to be indicative of a relapse. However, the association of a raised faecal calprotectin and relapse is not universal and may be explained by the different patterns of mucosal inflammatory activity that exist. In conclusion, we put forward our hypothesis that changes such as a rise in faecal calprotectin levels may be more predictive of a relapse than absolute values.

摘要

克罗恩病和溃疡性结肠炎是影响胃肠道的慢性炎症性疾病。粪便钙卫蛋白是存在于炎症细胞中的S-100钙结合蛋白家族的一种蛋白质复合物,可在粪便样本中检测到,它可作为肠道炎症的生物标志物。粪便钙卫蛋白升高已被证明反映了持续的黏膜炎症的存在,这种炎症会随着黏膜愈合而改善。本综述的目的是评估关于粪便钙卫蛋白预测炎症性肠病复发能力的现有证据。多项回顾性研究表明,与未复发患者相比,复发患者粪便中的钙卫蛋白水平显著更高,尤其是在溃疡性结肠炎患者中。克罗恩病患者术后粪便钙卫蛋白升高也被证明提示复发。然而,粪便钙卫蛋白升高与复发之间的关联并非普遍存在,这可能是由存在的不同黏膜炎症活动模式所解释的。总之,我们提出我们的假设,即粪便钙卫蛋白水平升高之类的变化可能比绝对值更能预测复发。

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