Ho Shaun S, Wall Catherine, Gearry Richard B, Keenan Jacqueline, Day Andrew S
Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.
Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
Inflamm Intest Dis. 2020 Nov;5(4):212-220. doi: 10.1159/000510682. Epub 2020 Oct 14.
Although collecting faeces and blood samples are considered non-invasive methods of monitoring Crohn's disease (CD), these methods are less preferred by some patients. This study utilized urine as an alternative to evaluate four disease biomarkers in young adults with active CD before and after exclusive enteral nutrition (EEN) therapy.
Urine samples collected at baseline (W0) and after 8 weeks (W8) of EEN therapy were assayed by ELISA for levels of intestinal fatty acid-binding protein (I-FABP), liver fatty acid-binding protein (L-FABP), claudin-3, and calprotectin. Levels of each biomarker were also compared with standard clinical parameters, including disease indexes, nutrient, and inflammatory markers.
Of the paired urine samples from 14 patients, 10 were female and 12 were newly diagnosed with CD. Urinary I-FABP: Cr (standardized to urine Cr) levels were significantly reduced, while urinary L-FABP: Cr levels increased following EEN therapy. Urinary L-FABP: Cr correlated positively with serum insulin-like growth factor 1 (IGF-1) ( = 0.60, = 0.02). Urinary CLND3: Cr and calprotectin: Cr levels were not significantly different after treatment.
I-FABP is a potential urinary biomarker of disease activity in adults with CD, while urinary L-FABP may be an indirect marker of nutritional status in adults with CD. CLND3 and calprotectin do not appear to have roles as urinary biomarkers in CD. These findings warrant further investigations using a larger sample size.
尽管收集粪便和血液样本被认为是监测克罗恩病(CD)的非侵入性方法,但一些患者不太愿意采用这些方法。本研究利用尿液作为替代手段,评估了接受全肠内营养(EEN)治疗前后的年轻成年活动性CD患者的四种疾病生物标志物。
通过酶联免疫吸附测定法(ELISA)检测在基线(W0)和EEN治疗8周后(W8)收集的尿液样本中肠脂肪酸结合蛋白(I-FABP)、肝脂肪酸结合蛋白(L-FABP)、紧密连接蛋白-3和钙卫蛋白的水平。还将每种生物标志物的水平与标准临床参数进行比较,包括疾病指数、营养和炎症标志物。
在14例患者的配对尿液样本中,10例为女性,12例为新诊断的CD患者。EEN治疗后,尿I-FABP:Cr(标准化至尿肌酐)水平显著降低,而尿L-FABP:Cr水平升高。尿L-FABP:Cr与血清胰岛素样生长因子1(IGF-1)呈正相关(r = 0.60,P = 0.02)。治疗后尿CLND3:Cr和钙卫蛋白:Cr水平无显著差异。
I-FABP是成年CD患者疾病活动的潜在尿液生物标志物,而尿L-FABP可能是成年CD患者营养状况的间接标志物。CLND3和钙卫蛋白似乎在CD中不作为尿液生物标志物发挥作用。这些发现需要使用更大样本量进行进一步研究。