Shi Xue, Yang Wei, Wang Nian, Zhu Junyi
Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Department of Gastroenterology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang.
Medicine (Baltimore). 2019 Aug;98(33):e16622. doi: 10.1097/MD.0000000000016622.
This study aimed to investigate the correlation of serum Jun-amino-terminal kinase (JNK) pathway-associated phosphatase (JKAP) level with disease risk, severity, inflammation, and treatment response to tumor necrosis factor (TNF)-α inhibitor in Crohn disease (CD) patients.
Ninety-six active CD patients and 90 healthy controls (HCs) were consecutively enrolled. Serum JKAP level of participants was determined via enzyme-linked immunosorbent assay (ELISA). In CD patients, C-reactive protein (CRP), erythrocyte sedimentation rate, Crohn disease activity index (CDAI), and inflammatory cytokine levels (determined by ELISA) were recorded. All CD patients underwent infliximab (IFX) treatment for 12 weeks, then treatment response (defined as decrement of CDAI ≥70) was assessed at week 12 (W12).
Serum JKAP level in CD patients was lower compared to HCs, and it disclosed a good predictive value for decreased CD risk; meanwhile, it was negatively correlated with CRP level, CDAI score, TNF-α, interleukin (IL)-6, and IL-17 levels in CD patients. Sixty-eight (70.8%) patients achieved treatment response to IFX at W12, and JKAP level was increased at W12 compared to baseline. Interestingly, baseline JKAP level in response patients was decreased compared to nonresponse patients, and it exhibited a good predictive value for decreased treatment response to IFX, multivariate logistic regression revealed that JKAP was an independent factor for predicting reduced IFX response.
Circulating JKAP expression correlates with decreased disease risk, activity, and inflammation level, and it could be served as a novel biomarker for predicting reduced clinical response to TNF-α inhibitor in CD patients.
本研究旨在探讨克罗恩病(CD)患者血清Jun氨基末端激酶(JNK)通路相关磷酸酶(JKAP)水平与疾病风险、严重程度、炎症及肿瘤坏死因子(TNF)-α抑制剂治疗反应之间的相关性。
连续纳入96例活动期CD患者和90例健康对照者(HCs)。通过酶联免疫吸附测定(ELISA)法测定参与者的血清JKAP水平。记录CD患者的C反应蛋白(CRP)、红细胞沉降率、克罗恩病活动指数(CDAI)及炎症细胞因子水平(通过ELISA法测定)。所有CD患者接受英夫利昔单抗(IFX)治疗12周,然后在第12周(W12)评估治疗反应(定义为CDAI降低≥70)。
与HCs相比,CD患者血清JKAP水平较低,且对降低CD风险具有良好的预测价值;同时,其与CD患者的CRP水平、CDAI评分、TNF-α、白细胞介素(IL)-6及IL-17水平呈负相关。68例(70.8%)患者在W12时达到对IFX的治疗反应,与基线相比,W12时JKAP水平升高。有趣的是,反应患者的基线JKAP水平低于无反应患者,且其对IFX治疗反应降低具有良好的预测价值,多因素逻辑回归显示JKAP是预测IFX反应降低的独立因素。
循环JKAP表达与疾病风险降低、活动度及炎症水平相关,可作为预测CD患者对TNF-α抑制剂临床反应降低的新型生物标志物。