Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan.
Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
J Gastroenterol. 2020 May;55(5):515-522. doi: 10.1007/s00535-019-01661-y. Epub 2020 Jan 24.
Various serologic markers such as anti-glycoprotein 2 antibodies and anti-Saccharomyces cerevisiae antibodies have been reported to be diagnostically useful in Crohn's disease. Mitsuyama et al. reported that antibodies to Crohn's disease peptide 353, a newly proposed serologic marker, were more useful in Japanese adults than anti-Saccharomyces. We addressed the same issue in Japanese children and adolescents.
Prospectively enrolled subjects under 17 years old assessed and treated at 12 pediatric centers in Japan included groups with Crohn's disease, ulcerative colitis, other intestinal diseases, or good health. The 3 serum markers were analyzed by enzyme-linked immunosorbent assays.
Enrolled subjects, numbering 367, included 120 with Crohn's disease, 148 with ulcerative colitis, 56 with other intestinal diseases, and 43 healthy subjects. In Crohn's disease, anti-Crohn's disease peptide 353, anti-glycoprotein 2, and anti-Saccharomyces concentrations (median, 2.25, 3.0, and 8.9 U/mL) were significantly greater than in ulcerative colitis (1.1, 1.9, and 3.4; all P < 0.001), other intestinal diseases (1.1, 1.85, and 2.95; all P < 0.001), and healthy controls (1.1, 1.7, and 2.8; all P < 0.001), respectively. At 95% specificity, sensitivity of anti-Crohn's disease peptide (45.0%) was significantly higher than for anti-glycoprotein 2 (30.8%; P < 0.05) or anti-Saccharomyces (26.7%; P < 0.01).
Anti-Crohn's disease peptide 353 proved more useful for diagnosis of Crohn's disease in Japanese children than the other 2 markers. To our knowledge, this is the first pediatric report to that effect.
多种血清标志物，如抗糖蛋白 2 抗体和抗酿酒酵母抗体，已被报道在克罗恩病的诊断中有一定的作用。Mitsuyama 等人报告称，新提出的血清标志物——克罗恩病肽 353 抗体，在日本成年人中的诊断价值高于抗酿酒酵母抗体。我们在日本儿童和青少年中也研究了这一问题。
前瞻性纳入了在日本 12 家儿科中心评估和治疗的 17 岁以下的受试者，包括克罗恩病、溃疡性结肠炎、其他肠道疾病和健康人群。通过酶联免疫吸附试验分析了 3 种血清标志物。
共纳入 367 名受试者，其中 120 名为克罗恩病，148 名为溃疡性结肠炎，56 名为其他肠道疾病，43 名为健康对照。在克罗恩病中，抗克罗恩病肽 353、抗糖蛋白 2 和抗酿酒酵母抗体的浓度（中位数，2.25、3.0 和 8.9 U/mL）显著高于溃疡性结肠炎（1.1、1.9 和 3.4；均 P < 0.001）、其他肠道疾病（1.1、1.85 和 2.95；均 P < 0.001）和健康对照组（1.1、1.7 和 2.8；均 P < 0.001）。当特异性为 95%时，抗克罗恩病肽的敏感性（45.0%）显著高于抗糖蛋白 2（30.8%；P < 0.05）或抗酿酒酵母（26.7%；P < 0.01）。
抗克罗恩病肽 353 对日本儿童克罗恩病的诊断比其他 2 种标志物更有价值。据我们所知，这是首次在儿科人群中得出的报告。
