Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Aliment Pharmacol Ther. 2020 Jul;52(2):284-291. doi: 10.1111/apt.15870. Epub 2020 Jun 7.
Oncostatin M is upregulated in Crohn's disease inflamed intestinal mucosa, and has been suggested as a promising biomarker to predict responsiveness to anti-TNF therapy in patients with inflammatory bowel diseases.
To evaluate the suitability of serum oncostatin M as a predictive marker of response to infliximab in Crohn's disease.
We included patients treated with infliximab monotherapy. All patients underwent colonoscopy at week 54 to evaluate mucosal healing. Serum oncostatin M and faecal calprotectin were measured at baseline and after 14 weeks of treatment. Mann-Whitney test was used to evaluate correlation of oncostatin M and faecal calprotectin at baseline and week 14 with mucosal healing at week 54. Their accuracy in predicting mucosal healing was assessed by area under the curve (AUC).
In a cohort of 45 included patients, 27 displayed mucosal healing. At both baseline and week 14, oncostatin M levels were significantly lower in patients with mucosal healing than in patients not achieving this endpoint (P < 0.001). Faecal calprotectin levels at week 14 were lower also in responders than nonresponders (P < 0.001). Oncostatin M values at baseline and week 14 were significantly associated (Spearman correlation = 0.92, P < 0.001). The diagnostic accuracy of oncostatin M at baseline in predicting mucosal healing (AUC = 0.91) was greater than faecal calprotectin (AUC = 0.51, P < 0.001).
These results suggest that oncostatin M can predict the outcome of infliximab treatment. Compared with faecal calprotectin, the predictive capability of oncostatin M was appreciable at baseline, thus indicating oncostatin M as a promising biomarker for driving therapeutic choices in Crohn's disease.
在克罗恩病炎症性肠黏膜中，骨调素 M 上调，并被认为是预测炎症性肠病患者对 TNF 拮抗剂治疗反应的有前途的生物标志物。
评估血清骨调素 M 作为克罗恩病患者对英夫利昔单抗反应的预测标志物的适用性。
我们纳入了接受英夫利昔单抗单药治疗的患者。所有患者在第 54 周接受结肠镜检查以评估黏膜愈合情况。在基线和治疗 14 周时测量血清骨调素 M 和粪便钙卫蛋白。采用 Mann-Whitney 检验评估基线和第 14 周时骨调素 M 和粪便钙卫蛋白与第 54 周时黏膜愈合的相关性。通过曲线下面积（AUC）评估其预测黏膜愈合的准确性。
在纳入的 45 例患者队列中，有 27 例显示黏膜愈合。在基线和第 14 周时，黏膜愈合患者的骨调素 M 水平均显著低于未达到这一终点的患者（P<0.001）。在应答者中，粪便钙卫蛋白水平在第 14 周也较低（P<0.001）。基线和第 14 周时的骨调素 M 值显著相关（Spearman 相关系数=0.92，P<0.001）。基线时骨调素 M 预测黏膜愈合的诊断准确性（AUC=0.91）大于粪便钙卫蛋白（AUC=0.51，P<0.001）。
这些结果表明，骨调素 M 可以预测英夫利昔单抗治疗的结果。与粪便钙卫蛋白相比，骨调素 M 的预测能力在基线时就很明显，因此表明骨调素 M 是克罗恩病治疗决策的有前途的生物标志物。
