联合使用 3 种血清学标志物在犬慢性肠病的诊断和监测中的应用。
Utility of the combined use of 3 serologic markers in the diagnosis and monitoring of chronic enteropathies in dogs.
机构信息
Vetica Labs, Inc., San Diego, California, USA.
Cabrillo Pet Hospital, San Diego, California, USA.
出版信息
J Vet Intern Med. 2021 May;35(3):1306-1315. doi: 10.1111/jvim.16132. Epub 2021 May 7.
BACKGROUND
Dogs with chronic enteropathies (CE) displayed elevated IgA seropositivity against specific markers that can be used to develop a novel test.
OBJECTIVE
To assess a multivariate test to aid diagnosis of CE in dogs and to monitor treatment-related responses.
ANIMALS
One hundred fifty-seven dogs with CE/inflammatory bowel disease (IBD), 24 dogs non-IBD gastrointestinal disorders, and 33 normal dogs.
METHODS
Prospective, multicenter, clinical study that enrolled dogs with gastrointestinal disorders. Serum sample collected at enrollment and up to 3 months follow-up measuring OmpC (ACA), canine calprotectin (ACNA), and gliadin-derived peptides (AGA) by ELISA.
RESULTS
Seropositivity was higher in CE/IBD than normal dogs (66% vs 9% for ACA; 55% vs 15% for ACNA; and 75% vs 6% for AGA; P < .001). When comparing CE/IBD with non-IBD disease, ACA and ACNA displayed discriminating properties (66%, 55% vs 12.5%, 29% respectively) while AGA separated CE from normal cohorts (54% vs 6%). A 3-marker algorithm at cutoff of ACA > 15, ACNA > 6, AGA > 60 differentiates CE/IBD and normal dogs with 90% sensitivity and 96% specificity; and CE/IBD and non-IBD dogs with 80% sensitivity and 86% specificity. Titers decreased after treatment (47%-99% in ACA, 13%-88% in ACNA, and 30%-85% in AGA), changes that were concurrent with clinical improvements.
CONCLUSION AND CLINICAL IMPORTANCE
An assay based on combined measurements of ACA, ACNA, and AGA is useful as a noninvasive diagnostic test to distinguish dogs with CE/IBD. The test also has the potential to monitor response to treatment.
背景
患有慢性肠炎（CE）的狗对特定标志物的 IgA 血清阳性率升高，这些标志物可用于开发新的检测方法。
目的
评估一种多变量检测方法，以辅助诊断患有 CE 的犬，并监测与治疗相关的反应。
动物
157 只患有 CE/炎症性肠病（IBD）的犬、24 只非 IBD 胃肠道疾病的犬和 33 只正常犬。
方法
这项前瞻性、多中心的临床研究纳入了患有胃肠道疾病的犬。在入组时和随访 3 个月内采集血清样本，通过 ELISA 检测 OmpC（ACA）、犬 calprotectin（ACNA）和麦醇溶蛋白衍生肽（AGA）。
结果
CE/IBD 犬的血清阳性率高于正常犬（ACA 为 66%比 9%，ACNA 为 55%比 15%，AGA 为 75%比 6%；P<0.001）。与非 IBD 疾病相比，ACA 和 ACNA 具有鉴别诊断特性（ACA 为 66%，55%，而非 IBD 疾病为 12.5%，29%；AGA 为 54%，6%）。ACA>15、ACNA>6、AGA>60 的 3 标志物算法能够区分 CE/IBD 和正常犬，其敏感性为 90%，特异性为 96%；区分 CE/IBD 和非 IBD 犬的敏感性为 80%，特异性为 86%。在治疗后，ACA 的滴度下降（47%-99%），ACNA 的滴度下降（13%-88%），AGA 的滴度下降（30%-85%），这些变化与临床改善同时发生。
结论和临床意义
基于 ACA、ACNA 和 AGA 联合测量的检测方法可作为一种非侵入性诊断检测方法，用于区分患有 CE/IBD 的犬。该检测方法还有望用于监测治疗反应。
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