Budzynska A, Gawron-Kiszka M, Nowakowska-Dulawa E, Spiewak J, Lesinska M, Kukla M, Waluga M, Hartleb M
Department of Gastroenterology and Hepatology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland.
J Physiol Pharmacol. 2017 Dec;68(6):859-865.
Serum neutrophil gelatinase-associated lipocalin (NGAL) is a low molecular weight protein released from activated neutrophils and intestine epithelium whose mRNA expression is increased in inflamed intestinal tissue. The purpose of this study was to explore the relationship between serum NGAL level and activity of inflammatory bowel diseases. A total of 120 patients, 79 with Crohn's disease (CD) and 41 with ulcerative colitis (UC) were prospectively included into the study. Serum NGAL was measured by ELISA. The inflammatory activity of UC was assessed by Mayo score and of CD by CDAI and SES-CD scoring systems. Increasing endoscopic severity of UC from remission/mild to moderate/severe was associated with increasing NGAL levels from 46.9 to 66.4 ng/ml (P = 0.002). NGAL concentrations were significantly lower in patients with complete endoscopic and histologic remission than in the active UC (46.9 versus 66.4 ng/ml, P = 0.009). Also deterioration of the clinical activity of UC patients was associated with increasing level of NGAL from 44.9 in remission/mild to 68.0 ng/ml in moderate/severe grade (P = 0.002). NGAL levels correlated with CRP (r = 0.49), ESR (r = 0.48) and iron concentrations (r = -0.63), but not with faecal calprotectin. NGAL showed ability to distinguish endoscopically active from inactive UC with AUC-ROC of 0.758 (sensitivity 96% and specificity 54%). However NGAL levels showed no significant relationship with either clinical or endoscopic activity of CD. We conclude that serum NGAL level corresponds to clinical and endoscopic activity of UC and accurately predicts disease endoscopic remission.
血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是一种由活化的中性粒细胞和肠上皮细胞释放的低分子量蛋白质，其mRNA表达在炎症性肠组织中增加。本研究的目的是探讨血清NGAL水平与炎症性肠病活动度之间的关系。共有120例患者前瞻性纳入研究，其中79例克罗恩病（CD）患者和41例溃疡性结肠炎（UC）患者。采用酶联免疫吸附测定法（ELISA）检测血清NGAL。UC的炎症活动度通过梅奥评分评估，CD的炎症活动度通过CDAI和SES-CD评分系统评估。UC内镜严重程度从缓解/轻度增加到中度/重度与NGAL水平从46.9 ng/ml增加到66.4 ng/ml相关（P = 0.002）。内镜和组织学完全缓解的患者NGAL浓度显著低于活动期UC患者（46.9 ng/ml对66.4 ng/ml，P = 0.009）。UC患者临床活动度的恶化也与NGAL水平增加相关，从缓解/轻度时的44.9 ng/ml增加到中度/重度时的68.0 ng/ml（P = 0.002）。NGAL水平与CRP（r = 0.49）、ESR（r = 0.48）和铁浓度（r = -0.63）相关，但与粪便钙卫蛋白无关。NGAL能够区分内镜下活动期与非活动期UC，曲线下面积（AUC-ROC）为0.758（敏感性96%，特异性54%）。然而，NGAL水平与CD的临床或内镜活动度均无显著关系。我们得出结论，血清NGAL水平与UC的临床和内镜活动度相符，并能准确预测疾病的内镜缓解。
