Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland.
Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland.
Adv Med Sci. 2020 Sep;65(2):259-264. doi: 10.1016/j.advms.2020.03.004. Epub 2020 Apr 28.
The aim of the study was to compare the clinical activity and inflammatory markers with the endoscopic activity of ulcerative colitis (UC) and mucosal healing.
The study included 50 children aged 2-18 years (27 girls, 23 boys) diagnosed with UC at various stages of the disease; 8 children were assessed twice. In 20 children, colonoscopy revealed pancolitis, in 24 - left-sided colitis, and in 6 - ulcerative proctitis. The clinical activity of UC was assessed according to the Pediatric Ulcerative Colitis Activity Index (PUCAI). Endoscopic index of the colon inflammation was assessed according to the Rachmilewitz scoring. We assessed the clinical activity of UC, the concentration of fecal calprotectin (FC), seromucoid, metalloproteinase-3 (MMP-3) and C-reactive protein (CRP).
The study demonstrated significant decrease in the clinical activity, FC, seromucoid and MMP-3 in endoscopic remission. We found a strong positive correlation between PUCAI, FC, serum seromucoid and serum MMP-3 with the endoscopic activity. However, we found no relationship between the concentration of CRP and the endoscopic activity of the disease. Among the studied markers, seromucoid exhibited the best performance in distinguishing between patients with endoscopic remission and endoscopically active disease.
The examined inflammatory markers such as FC, as well as serum seromucoid and MMP-3 levels may be helpful in the assessment of large intestine mucosal healing.
本研究旨在比较溃疡性结肠炎（UC）的临床活动和炎症标志物与内镜活动和黏膜愈合的关系。
本研究纳入了 50 名 2-18 岁的儿童（27 名女孩，23 名男孩），他们在疾病的不同阶段被诊断为 UC；其中 8 名患儿接受了两次评估。20 名患儿的结肠镜检查显示全结肠炎，24 名患儿显示左半结肠炎，6 名患儿显示溃疡性直肠炎。UC 的临床活动根据儿科溃疡性结肠炎活动指数（PUCAI）进行评估。结肠炎症的内镜指数根据 Rachmilewitz 评分进行评估。我们评估了 UC 的临床活动、粪便钙卫蛋白（FC）、血清黏蛋白、基质金属蛋白酶-3（MMP-3）和 C 反应蛋白（CRP）的浓度。
研究表明，内镜缓解时 UC 的临床活动、FC、血清黏蛋白和 MMP-3 显著降低。我们发现 PUCAI、FC、血清黏蛋白和血清 MMP-3 与内镜活动之间存在强烈的正相关。然而，我们发现 CRP 浓度与疾病的内镜活动之间没有关系。在研究的标志物中，黏蛋白在区分内镜缓解和内镜活跃疾病患者方面表现最佳。
检查的炎症标志物如 FC 以及血清黏蛋白和 MMP-3 水平可能有助于评估大肠黏膜愈合。
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