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血清肿瘤坏死因子配体超家族成员 11 预测接受抗 TNF 治疗的炎症性肠病患者的黏膜愈合,但不能预测 vedolizumab 治疗的患者。

Serum oncostatin M predicts mucosal healing in patients with inflammatory bowel diseases treated with anti-TNF, but not vedolizumab.

机构信息

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, via Roma, 67, Pisa 56100, Italy.

Department of Department of Surgery, Oncology and Gastroenterology -DiSCOG, University of Padua, Padua, Italy.

出版信息

Dig Liver Dis. 2022 Oct;54(10):1367-1373. doi: 10.1016/j.dld.2022.03.008. Epub 2022 Apr 4.

Abstract

BACKGROUND

Oncostatin M was recently highlighted as a promising biomarker for therapeutic effectiveness in inflammatory bowel diseases (IBD), with particular regard for infliximab. The primary aim was to evaluate the ability of serum oncostatin M to predict endoscopic response to different drugs in IBD.

METHODS

We selected two different cohorts of patients with IBD, treated with anti-TNF (infliximab and adalimumab) or with vedolizumab. Therapeutic response was evaluated at week 54 in terms of mucosal healing. Serum oncostatin M and C-reactive protein were measured at baseline; fecal calprotectin was measured at baseline and after 14 weeks of treatment. We evaluated the association of these biomarkers with mucosal healing at week 54.

RESULTS

Among 66 patients treated with anti-TNFs and 68 treated with vedolizumab, 35 and 31 attained mucosal healing, respectively. Mucosal healing at 54 weeks was significantly associated with low oncostatin M levels at baseline in the anti-TNF cohort; the diagnostic accuracy of oncostatin M at baseline in predicting mucosal healing was 0.91 (95% CI 0.84 to 0.99) in the anti-TNF cohort and 0.56 (95% CI 0.43 to 0.70, P < 0.001) in the vedolizumab cohort. Mucosal healing was also associated with low fecal calprotectin levels at week 14 in both cohorts.

CONCLUSION

Our study suggests that serum oncostatin M is a drug-specific biomarker, since it could be used to predict therapeutic effectiveness to anti-TNFs but not to vedolizumab. Moreover, these results emphasize the utility of serum oncostatin M measurement in patients treated with anti-TNF.

摘要

背景

最近,Oncostatin M 被强调为炎症性肠病(IBD)治疗效果的有前途的生物标志物,特别是针对英夫利昔单抗。主要目的是评估血清 Oncostatin M 预测 IBD 中不同药物内镜反应的能力。

方法

我们选择了两个不同的 IBD 患者队列,分别接受抗 TNF(英夫利昔单抗和阿达木单抗)或 vedolizumab 治疗。在第 54 周根据黏膜愈合评估治疗反应。在基线时测量血清 Oncostatin M 和 C 反应蛋白,在基线和治疗 14 周后测量粪便钙卫蛋白。我们评估了这些生物标志物与第 54 周黏膜愈合的相关性。

结果

在 66 名接受抗 TNF 治疗的患者和 68 名接受 vedolizumab 治疗的患者中,分别有 35 名和 31 名达到了黏膜愈合。在抗 TNF 队列中,第 54 周的黏膜愈合与基线时低 Oncostatin M 水平显著相关;在抗 TNF 队列中,基线时 Oncostatin M 预测黏膜愈合的诊断准确性为 0.91(95%CI 0.84 至 0.99),而在 vedolizumab 队列中为 0.56(95%CI 0.43 至 0.70,P<0.001)。在两个队列中,第 14 周的粪便钙卫蛋白水平较低也与黏膜愈合相关。

结论

我们的研究表明,血清 Oncostatin M 是一种药物特异性生物标志物,因为它可用于预测抗 TNF 的治疗效果,但不能预测 vedolizumab 的治疗效果。此外,这些结果强调了在接受抗 TNF 治疗的患者中测量血清 Oncostatin M 的实用性。

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