Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
J Gastrointestin Liver Dis. 2023 Dec 22;32(4):438-443. doi: 10.15403/jgld-4932.
Fecal calprotectin (FC) is a biomarker of gut inflammation, and Escherichia coli Nissle 1917 (EcN) is a probiotic strain able to reduce gut inflammation and maintain disease remission in patients with inflammatory bowel disease (IBD). The aim is to assess the effects of EcN administration in patients with IBD in clinical remission and altered FC values.
We prospectively included 82 patients with ulcerative colitis (UC) (n=49) and Crohn's disease (CD) (n=33) in clinical remission and with FC values above 250 mcg/g (T0) who were treated with EcN alone for 2 months. FC values were assessed at the end of EcN treatment (T1) and clinical disease activity at 3 months (T2).
At T1 median FC values were significantly lower compared to T0 both in patients with CD (312 mcg/g vs 626 mcg/g, p<0.0001) and UC (100 mcg/g vs 584 mcg/g; p<0.0001). Patients with UC who experienced disease relapse at T2 had lesser reduction in median FC values at T1 (-229 mcg/g, vs -397 mcg/g, p=0.049), while in patients with CD we observed no statistically significant difference (-358 mcg/g, vs -427; p=0.568). In patients with UC, a reduction of at least 532 mcg/g in FC had an accuracy of 69.7% and a positive predictive value of 65.7% in predicting maintenance of remission.
A short course of EcN was associated with a reduction of FC values in patients with IBD in clinical remission and baseline altered FC values, and in patients with UC this decrease was associated with maintenance of clinical remission.
粪便钙卫蛋白（FC）是肠道炎症的生物标志物，而大肠杆菌 Nissle 1917（EcN）是一种益生菌菌株，能够减轻炎症性肠病（IBD）患者的肠道炎症并维持疾病缓解。目的是评估在临床缓解和 FC 值改变的 IBD 患者中给予 EcN 的效果。
我们前瞻性地纳入了 82 例处于临床缓解期且 FC 值高于 250 mcg/g（T0）的溃疡性结肠炎（UC）（n=49）和克罗恩病（CD）（n=33）患者，这些患者单独接受 EcN 治疗 2 个月。在 EcN 治疗结束时（T1）评估 FC 值，并在 3 个月时（T2）评估临床疾病活动度。
在 T1，与 T0 相比，CD（312 mcg/g 比 626 mcg/g，p<0.0001）和 UC（100 mcg/g 比 584 mcg/g；p<0.0001）患者的 FC 值中位数均显著降低。在 T2 时发生疾病复发的 UC 患者，在 T1 时 FC 值中位数降低幅度较小（-229 mcg/g 比-397 mcg/g，p=0.049），而在 CD 患者中，这一差异无统计学意义（-358 mcg/g 比-427 mcg/g；p=0.568）。在 UC 患者中，FC 值至少降低 532 mcg/g 的准确性为 69.7%，预测缓解维持的阳性预测值为 65.7%。
短期 EcN 治疗与临床缓解和基线改变的 FC 值的 IBD 患者的 FC 值降低有关，在 UC 患者中，这种降低与临床缓解的维持有关。
