Department of Gastroenterology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Front Immunol. 2022 Mar 4;13:865968. doi: 10.3389/fimmu.2022.865968. eCollection 2022.
With the increasing incidence and prevalence, Crohn's disease (CD) has become one of the most challenging diseases in both diagnosis and treatment of gastroenterology. Evaluation of the disease activity and mucosal healing guides clinical decisions regarding subsequent therapy for CD. In this study, we enrolled a total of 144 patients with CD and 239 healthy controls were enrolled. Clinical characteristics and laboratory parameters of enrolled subjects were retrieved from the electronic medical record database of our hospital. Serum cytokine levels were measured by enzyme-linked immunosorbent assay (ELISA). Mucosa expression levels of inflammatory agents were measured by quantitative RT-PCR (qRT-PCR). We identified two neutrophil-based indexes, the neutrophil-to-albumin ratio (NAR) and neutrophil-to-bilirubin ratio (NBR), both of which had not yet been explored in CD or UC. NAR and NBR were significantly increased in patients with CD compared to those in healthy controls, and both indexes showed significantly positive correlations with CD activity and inflammatory load. In note, NAR and NBR showed better performance than blood neutrophil percentage, serum albumin, or bilirubin alone in these scenarios. More importantly, both NAR and NBR discriminated CD patients who completely or partially responded to infliximab (IFX) induction therapy from those with primary non-response. Our observations suggest that NAR and NBR may serve as promising biomarkers in the diagnosis and prediction of response to IFX therapy in CD.
随着发病率和患病率的增加，克罗恩病（CD）已成为消化内科诊断和治疗中最具挑战性的疾病之一。疾病活动度和黏膜愈合的评估指导着 CD 后续治疗的临床决策。在这项研究中，我们共纳入了 144 例 CD 患者和 239 例健康对照者。纳入对象的临床特征和实验室参数从我院电子病历数据库中检索。采用酶联免疫吸附试验（ELISA）测定血清细胞因子水平。采用实时定量 RT-PCR（qRT-PCR）测定炎症介质的黏膜表达水平。我们发现了两个基于中性粒细胞的指标，中性粒细胞与白蛋白比值（NAR）和中性粒细胞与胆红素比值（NBR），这两个指标在 CD 或 UC 中尚未被探讨过。与健康对照组相比，CD 患者的 NAR 和 NBR 明显升高，且这两个指标均与 CD 活动度和炎症负荷呈显著正相关。值得注意的是，在这些情况下，NAR 和 NBR 比血中性粒细胞百分比、血清白蛋白或胆红素单独使用具有更好的性能。更重要的是，NAR 和 NBR 可以区分对英夫利昔单抗（IFX）诱导治疗完全或部分应答的 CD 患者与原发性无应答者。我们的观察结果表明，NAR 和 NBR 可能是 CD 诊断和预测 IFX 治疗反应的有前途的生物标志物。
