Liu Caiguang, Zhan Shukai, Li Na, Tu Tong, Lin Jianming, Li Manying, Chen Minhu, Zeng Zhirong, Zhuang Xiaojun
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Scand J Gastroenterol. 2023 Jul-Dec;58(9):988-997. doi: 10.1080/00365521.2023.2200518. Epub 2023 Apr 18.
The indolent course of treatment-naive patients with inflammatory bowel disease (IBD) is confirmed predictable based on clinical characteristics. Current evidences supported that bile acids (BAs) alteration might be promising biomarkers in the field of IBD. We aimed to analyze the alterations of BAs as the disease progresses and explore their predictive value for indolent course of IBD.
The indolent course of IBD was defined as a disease course without need for strict interventions throughout the entire follow-up. A targeted metabolomics method was used to detect the concentration of 27 BAs from serum sample in treatment-naive patients with IBD (Crohn's disease [CD], = 27; ulcerative colitis [UC], = 50). Patients with CD and UC were individually divided into two groups for further study according to the median time of indolent course. The overall BAs profile and the clinical value of BAs in predicting indolent course of IBD were identified between different groups.
For CD, the levels of deoxycholic acid, glycodeoxycholic acid, taurodeoxycholic acid, glycolithocholic acid-3-sulfate disodium salt and iso-lithocholic acid were significantly increased in patients with indolent course > 18 M ( < 0.05). These five BAs owned 83.5% accuracy for predicting indolent course over 18 months in CD. For UC, the concentration of deoxycholic acid and glycodeoxycholic acid were significantly higher, while dehydrocholic acid were lower in patients with indolent course > 48 M ( < 0.05). These three BAs predicted indolent course over 48 months of 69.8% accuracy in UC.
The specific BAs alterations might be potential biomarkers in predicting disease course of IBD patients.
初治炎症性肠病（IBD）患者的惰性病程可根据临床特征得到证实具有可预测性。目前的证据支持胆汁酸（BAs）改变可能是IBD领域有前景的生物标志物。我们旨在分析随着疾病进展BAs的变化，并探讨它们对IBD惰性病程的预测价值。
IBD的惰性病程定义为在整个随访期间无需严格干预的疾病进程。采用靶向代谢组学方法检测初治IBD患者（克罗恩病[CD]，n = 27；溃疡性结肠炎[UC]，n = 50）血清样本中27种BAs的浓度。根据惰性病程的中位时间，将CD和UC患者分别分为两组进行进一步研究。确定不同组之间BAs的总体概况及其在预测IBD惰性病程中的临床价值。
对于CD，惰性病程>18个月的患者中，脱氧胆酸、甘氨脱氧胆酸、牛磺脱氧胆酸、甘氨石胆酸-3-硫酸二钠盐和异石胆酸水平显著升高（P<0.05）。这五种BAs对预测CD中超过18个月的惰性病程的准确率为83.5%。对于UC，惰性病程>48个月的患者中，脱氧胆酸和甘氨脱氧胆酸浓度显著更高，而脱氢胆酸更低（P<0.05）。这三种BAs对预测UC中超过48个月的惰性病程的准确率为69.8%。
特定的BAs改变可能是预测IBD患者疾病进程的潜在生物标志物。
