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生物标志物在炎症性肠病中的定位和作用。

Positioning and Usefulness of Biomarkers in Inflammatory Bowel Disease.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan,

Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Digestion. 2023;104(1):30-41. doi: 10.1159/000527846. Epub 2022 Nov 18.


DOI:10.1159/000527846
PMID:36404714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9843547/
Abstract

BACKGROUND: Mucosal healing (MH) was proposed to be an ideal treatment goal for patients with inflammatory bowel disease (IBD). Instead of endoscopy to confirm MH, biomarkers are frequently used and have become an indispensable modality for the clinical examination of patients with IBD. SUMMARY: Common biomarkers of IBD include C-reactive protein (CRP), erythrocyte sedimentation rate, antineutrophil cytoplasmic antibodies, anti-Saccharomyces cerevisiae antibodies, leucine-rich α2 glycoprotein, fecal calprotectin (FCP), and the fecal immunochemical test. Biomarkers play five major roles in the management of IBD: (1) diagnosing and distinguishing between IBD and non-IBD or ulcerative colitis and Crohn's disease; (2) predicting treatment response, especially before administrating biologics; (3) monitoring and grasping endoscopic or histological disease activity; (4) replacing endoscopy for diagnosing MH, including endoscopic and histological remission; and (5) predicting recurrence before disease activity appears through symptoms. Many reports have demonstrated the usefulness of CRP and FCP for those five roles; however, they have limitations for diagnosing MH or predicting treatment response. In general, FCP has better ability in those positions than CRP; additionally, leucine-rich α2 glycoprotein can diagnose endoscopic disease activity better than CRP. The novel biomarker, prostaglandin E-major urinary metabolite, and anti-αvβ6 antibody are expected to be noninvasive and reliable biomarkers; however, more evidence is required for future studies. Oncostatin M and microRNA are also prospects, in addition to other familiar and novel biomarkers. KEY MESSAGES: Each biomarker has a useful feature; therefore, we should consider their features and use appropriate biomarkers for the five roles to enable noninvasive and smooth management of IBD.

摘要

背景:黏膜愈合(MH)被提议作为炎症性肠病(IBD)患者的理想治疗目标。替代内镜来确认 MH,生物标志物经常被使用,并已成为 IBD 患者临床检查不可或缺的方式。

摘要:IBD 的常见生物标志物包括 C 反应蛋白(CRP)、红细胞沉降率、抗中性粒细胞胞浆抗体、抗酿酒酵母抗体、富含亮氨酸的α2 糖蛋白、粪便钙卫蛋白(FCP)和粪便免疫化学试验。生物标志物在 IBD 的管理中发挥着五个主要作用:(1)诊断和区分 IBD 与非 IBD 或溃疡性结肠炎与克罗恩病;(2)预测治疗反应,特别是在给予生物制剂之前;(3)监测和掌握内镜或组织学疾病活动;(4)通过症状预测疾病活动出现之前的复发,用替代内镜来诊断 MH,包括内镜和组织学缓解;(5)替代内镜来诊断 MH,包括内镜和组织学缓解。许多报告表明 CRP 和 FCP 对这五个作用有用;然而,它们在诊断 MH 或预测治疗反应方面有局限性。一般来说,FCP 在这些方面比 CRP 有更好的能力;此外,富含亮氨酸的α2 糖蛋白可以比 CRP 更好地诊断内镜疾病活动。新型生物标志物,前列腺素 E-主要尿代谢物和抗-αvβ6 抗体有望成为非侵入性和可靠的生物标志物,但需要更多的证据来进行未来的研究。此外,还有其他熟悉和新型的生物标志物,如肿瘤坏死因子 M 和 microRNA。

关键信息:每个生物标志物都有有用的特征;因此,我们应该考虑它们的特征,并在五个作用中使用适当的生物标志物,以实现 IBD 的非侵入性和顺畅管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ea/9843547/b7275a1ae183/dig-0104-0030-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ea/9843547/b7275a1ae183/dig-0104-0030-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ea/9843547/b7275a1ae183/dig-0104-0030-g01.jpg

相似文献

[1]
Positioning and Usefulness of Biomarkers in Inflammatory Bowel Disease.

Digestion. 2023

[2]
Leucine-Rich Alpha-2 Glycoprotein Is a Reliable Serum Biomarker for Evaluating Clinical and Endoscopic Disease Activity in Inflammatory Bowel Disease.

Inflamm Bowel Dis. 2023-9-1

[3]
Both fecal calprotectin and fecal immunochemical tests are useful in children with inflammatory bowel disease.

J Gastroenterol. 2022-5

[4]
Noninvasive Fecal Immunochemical Testing and Fecal Calprotectin Predict Mucosal Healing in Inflammatory Bowel Disease: A Prospective Cohort Study.

Inflamm Bowel Dis. 2017-9

[5]
Serum leucine-rich alpha-2 glycoprotein and calprotectin in children with inflammatory bowel disease: A multicenter study in Japan.

J Gastroenterol Hepatol. 2023-7

[6]
Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review.

World J Gastroenterol. 2021-4-28

[7]
Fecal calprotectin measurement is a marker of short-term clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease.

World J Gastroenterol. 2017-11-7

[8]
Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease.

Inflamm Bowel Dis. 2012-2-16

[9]
The use of fecal calprotectin in monitoring activity of inflammatory bowel diseases.

Ter Arkh. 2019-5-16

[10]
New noninvasive biomarkers of intestinal inflammation and increased intestinal permeability in pediatric inflammatory bowel diseases and their correlation with fecal calprotectin: a pilot study.

Minerva Gastroenterol (Torino). 2023-12

引用本文的文献

[1]
Gut Feeling: Biomarkers and Biosensors' Potential in Revolutionizing Inflammatory Bowel Disease (IBD) Diagnosis and Prognosis-A Comprehensive Review.

Biosensors (Basel). 2025-8-7

[2]
Targeted urinary metabolomics combined with machine learning to identify biomarkers related to central carbon metabolism for IBD.

Front Mol Biosci. 2025-8-11

[3]
Decline in Serum Lysophosphatidylcholine Species in Patients with Severe Inflammatory Bowel Disease.

J Clin Med. 2025-8-4

[4]
Hotspots and trends of perianal fistula of Crohn's disease: A bibliometric analysis.

Medicine (Baltimore). 2025-8-8

[5]
Is Eosinophilic Colitis a Forerunner of Inflammatory Bowel Disease?

Curr Gastroenterol Rep. 2025-8-11

[6]
Efficacy and safety of vedolizumab in elderly and younger patients with moderate-to-severe ulcerative colitis: a retrospective real-world study in China.

BMC Gastroenterol. 2025-7-24

[7]
From Homeostasis To Inflammation To Autoimmunity: The Potential Impact of CRP.

Inflammation. 2025-7-18

[8]
Early Identification of Pediatric Inflammatory Bowel Disease Based on a Noninvasive Multivariable Predictive Model.

J Inflamm Res. 2025-7-12

[9]
Exploration of fecal microbiota in newly diagnosed patients with inflammatory bowel disease using shotgun metagenomics.

Front Cell Infect Microbiol. 2025-7-1

[10]
A Randomized Controlled Pilot Study Evaluating the Safety and Efficacy of Nifuroxazide in Patients with Ulcerative Colitis.

Drug Des Devel Ther. 2025-6-30

本文引用的文献

[1]
Serum Leucine-Rich Alpha-2 Glycoprotein in Quiescent Crohn's Disease as a Potential Surrogate Marker for Small-Bowel Ulceration detected by Capsule Endoscopy.

J Clin Med. 2022-4-29

[2]
Accuracy of Serum Leucine-Rich Alpha-2 Glycoprotein in Evaluating Endoscopic Disease Activity in Crohn's Disease.

Inflamm Bowel Dis. 2023-2-1

[3]
Serum oncostatin M predicts mucosal healing in patients with inflammatory bowel diseases treated with anti-TNF, but not vedolizumab.

Dig Liver Dis. 2022-10

[4]
Both fecal calprotectin and fecal immunochemical tests are useful in children with inflammatory bowel disease.

J Gastroenterol. 2022-5

[5]
High oncostatin M predicts lack of clinical remission for patients with inflammatory bowel disease on tumor necrosis factor α antagonists.

Sci Rep. 2022-1-24

[6]
Prostaglandin E-major urinary metabolite diagnoses mucosal healing in patients with ulcerative colitis in remission phase.

J Gastroenterol Hepatol. 2022-5

[7]
Comparison between Prostaglandin E-major urinary metabolite and C-reactive protein levels to reflect endoscopic scores in patients with ulcerative colitis.

Sci Rep. 2021-8-10

[8]
miRNA-Based Potential Biomarkers and New Molecular Insights in Ulcerative Colitis.

Front Pharmacol. 2021-7-9

[9]
Serum Leucine-Rich α Glycoprotein: A Novel Biomarker For Small Bowel Mucosal Activity in Crohn's Disease.

Clin Gastroenterol Hepatol. 2022-5

[10]
Leucine-rich alpha-2 glycoprotein as a marker of mucosal healing in inflammatory bowel disease.

Sci Rep. 2021-5-27

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