Institute of Pathology, University of Bern, Bern, Switzerland.
Department of Gastroenterology, Amsterdam Medical Center, Amsterdam, The Netherlands.
J Crohns Colitis. 2022 Aug 30;16(8):1321-1334. doi: 10.1093/ecco-jcc/jjac024.
Ulcerative colitis [UC] is characterised by an unpredictable disease course and variable response to therapy. Recent studies suggest a role for eosinophils in both pathogenesis and predicting treatment response. The goal of this study was to determine the association between eosinophils and clinical outcomes in UC.
A systematic review of the literature from database inception to May 2021 was performed to identify all studies evaluating the relationship between eosinophils and/or eosinophil-derived proteins [EDPs] and clinical outcomes, such as disease activity, clinical relapse, severity of disease, and response to treatment.
A total of 55 studies were identified. Of these, 34 studies evaluated the relationship between eosinophils in colonic tissue and outcomes and 15 in blood. Eighteen studies assessed the relationship between EDPs and outcomes. In 25 of 34 studies, a positive correlation between eosinophils and/or EDPs and disease activity was reported, three studies found a negative correlation, and nine studies found no correlation. Positive correlations between eosinophils and clinical relapse were shown in four of nine studies, and with disease outcome severity in five of seven studies. Four of 15 studies showed that subjects with higher eosinophil levels had a poor response to treatment.
These findings suggest that higher eosinophil levels may be associated with increased disease activity and poorer clinical outcomes and response to therapy. Future studies are needed to determine whether a distinct eosinophil-rich UC phenotype exists and whether eosinophil-targeted therapy can alter the disease course.
溃疡性结肠炎（UC）的疾病过程具有不可预测性，对治疗的反应也各不相同。最近的研究表明，嗜酸性粒细胞在发病机制和预测治疗反应中都具有一定作用。本研究旨在确定嗜酸性粒细胞与 UC 临床结局之间的关联。
从数据库建立到 2021 年 5 月，对文献进行了系统回顾，以确定所有评估嗜酸性粒细胞和/或嗜酸性粒细胞衍生蛋白（EDP）与疾病活动度、临床复发、疾病严重程度和治疗反应等临床结局之间关系的研究。
共确定了 55 项研究。其中，34 项研究评估了结肠组织中嗜酸性粒细胞与结局的关系，15 项研究评估了血液中嗜酸性粒细胞与结局的关系。18 项研究评估了 EDPs 与结局的关系。在 34 项研究中的 25 项研究中，报告了嗜酸性粒细胞和/或 EDPs 与疾病活动度之间存在正相关，3 项研究发现负相关，9 项研究未发现相关性。在 9 项研究中的 4 项研究中，嗜酸性粒细胞与临床复发呈正相关，在 7 项研究中的 5 项研究中与疾病结局严重程度呈正相关。在 15 项研究中的 4 项研究中，发现嗜酸性粒细胞水平较高的患者对治疗的反应较差。
这些发现表明，较高的嗜酸性粒细胞水平可能与疾病活动度增加以及临床结局和治疗反应较差相关。需要进一步的研究来确定是否存在嗜酸性粒细胞丰富的 UC 表型，以及是否可以通过靶向嗜酸性粒细胞的治疗来改变疾病进程。
