Ghasemi Fatemeh, Basirat Vahid, Izad Maryam, Tavassolifar Mohammad Javad, Yaseri Mehdi, Daryani Nasser Ebrahimi, Alebouyeh Masoud, Pourmand Mohammad Reza
Department of Pathobiology, Biotechnology Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and health services, Isfahan, Iran.
Iran J Public Health. 2022 Jul;51(7):1648-1657. doi: 10.18502/ijph.v51i7.10099.
Crohn's disease (CD) has a chronic course, which its recurrence varies widely among different patients. In this study we prospectively analyzed blood samples of 19 CD patients. Alteration in transcription of inflammatory and anti-inflammatory cytokines was analyzed compared with household members after three month follow up.
CD patients were diagnosed based on clinical symptoms, endoscopic and histopathologic characteristics. Nineteen CD patients and their households were evaluated from Jun 2019 to Feb 2021 at Tehran university hospitals. CD activity score, biological, clinical and demographic data of the patients were recorded at two time point intervals. Bacteriological tests were done using aerobic and anaerobic blood cultures. To investigate transcriptional alterations, peripheral blood mononuclear cells (PBMCs) were isolated using Ficol centrifugation method and relative quantitative real-time PCR was done to determine the expression level of IFN-γ, TNF-α, IL10, and FOXP3 cytokines.
Our results showed a correlation between fecal calprotectin level (709.8 ± 554.6), C-reactive protein concentration (18.1 ± 15.9), and erythrocyte sedimentation rate (30.4 ± 17.9) with disease activity (Flare/remission). IL10 and Foxp3 anti-inflammatory gene's expression were significantly ( = 0.003 for IL10 and = 0.008 Foxp3) higher during the flare and remission in patients with active disease respectively. Bacteriological examination showed infection with spp. and spp. in two CD patients during flares, which was correlated with upregulation and down-regulation of IL10, TNF-α, IFN-γ and FOXP3 proteins, respectively.
Occurrence of bacteremia, and higher amount of CAP, CRP and ESR are correlated with higher level of transcription for inflammatory cytokines, which could effectively reflect the disease activity. Raise in FoxP3 transcription proposed change in Treg sub-population in PBMC or its activity during the CD remission phase.
克罗恩病（CD）病程呈慢性，其复发在不同患者间差异很大。在本研究中，我们对19例CD患者的血样进行了前瞻性分析。在三个月的随访后，将炎症和抗炎细胞因子的转录变化与家庭成员进行了比较分析。
根据临床症状、内镜和组织病理学特征对CD患者进行诊断。2019年6月至2021年2月在德黑兰大学医院对19例CD患者及其家庭成员进行了评估。在两个时间点记录患者的CD活动评分、生物学、临床和人口统计学数据。使用需氧和厌氧血培养进行细菌学检测。为了研究转录变化，采用Ficol离心法分离外周血单个核细胞（PBMC），并进行相对定量实时PCR以确定IFN-γ、TNF-α、IL10和FOXP3细胞因子的表达水平。
我们的结果显示粪便钙卫蛋白水平（709.8±554.6）、C反应蛋白浓度（18.1±15.9）和红细胞沉降率（30.4±17.9）与疾病活动（发作/缓解）之间存在相关性。在疾病活动期的发作和缓解期，IL10和Foxp3抗炎基因的表达分别显著升高（IL10为 = 0.003，Foxp3为 = 0.008）。细菌学检查显示，两名CD患者在发作期间感染了 菌属和 菌属，这分别与IL10、TNF-α、IFN-γ和FOXP3蛋白的上调和下调相关。
菌血症的发生以及较高水平的CAP、CRP和ESR与炎症细胞因子的较高转录水平相关，这可以有效反映疾病活动。FoxP3转录的升高表明在CD缓解期PBMC中Treg亚群或其活性发生了变化。
