Barros Luisa Leite, Leite Gabriela, Morales Walter, Barlow Gillian M, de Azevedo Matheus Freitas Cardoso, de Sousa Carlos Alexandre, Damião Adérson Omar Mourão Cintra, Pimentel Mark, Farias Alberto Queiroz
Department of Gastroenterology, University of Sao Paulo School of Medicine, Av. Dr. Eneas C Aguiar 255, Sao Paulo-SP, 9117, Brazil.
Medically Associated Science and Technology (MAST) Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
BMC Gastroenterol. 2024 Dec 3;24(1):448. doi: 10.1186/s12876-024-03509-z.
Despite adequate treatment, a subgroup of patients with inflammatory bowel disease (IBD), including Crohn`s disease and ulcerative colitis, have persistent gastrointestinal symptoms that are not always related to mucosal damage. Recently, two autoantibodies, anti-CdtB and anti-vinculin, were validated as post-infectious IBS (PI-IBS) markers, however there is limited evidence of its diagnostic role in IBD population.
Patients with more than 3 bowel movements/day and indication of colonoscopy were enrolled. Samples were collected at the time of colonoscopy for assessment of serum levels of anti-CdtB and anti-vinculin antibodies.
A total of 160 subjects were included in 4 groups: active IBD (n = 44); quiescent IBD and chronic diarrhea IBD-IBS (n = 25); predominant-diarrhea IBS (n = 45) and controls (n = 46). The mean value of the optical density for anti-CdtB was 1.2 ± 0.65 in group 1, 1.27 ± 0.64 in group 2, 1.49 ± 0.47 in the group 3 and 1.6 ± 0.68 in group 4, p = 0.012. For anti-vinculin, optical densities were: 1.34 ± 0.78 in group 1, 1.46 ± 0.92 in group 2, 1.31 ± 0.79 in group 3 and 1.41 ± 0.86 for controls (p = 0.875). Using a cut-off of 1.56 for anti-CdtB, the positivity between groups was n = 10 (22.7%) in group 1, n = 9 (34.6%) in group 2, 19 (43.2%) in group 3, 21 (45.7%) in group 4 (p = 0.106). The positivity of anti-vinculin using a cut-off of 1.6 was n = 18 (40.9%) in group 1, n = 11 (42.3%), n = 15 (34.1%), n = 22 (47.8%) (p = 0.622).
Our findings show that anti-CdtB and anti-vinculin could not identify IBD-IBS patients or discriminate IBS-D from healthy controls.
尽管接受了充分治疗，但包括克罗恩病和溃疡性结肠炎在内的一部分炎症性肠病（IBD）患者仍有持续的胃肠道症状，这些症状并不总是与黏膜损伤相关。最近，两种自身抗体，即抗CdtB和抗纽蛋白，被确认为感染后肠易激综合征（PI-IBS）的标志物，然而，其在IBD人群中的诊断作用证据有限。
纳入每日排便超过3次且有结肠镜检查指征的患者。在结肠镜检查时采集样本，以评估血清中抗CdtB和抗纽蛋白抗体水平。
共160名受试者被纳入4组：活动期IBD（n = 44）；静止期IBD和慢性腹泻型IBD-IBS（n = 25）；以腹泻为主的肠易激综合征（n = 45）和对照组（n = 46）。抗CdtB的光密度平均值在第1组为1.2±0.65，第2组为1.27±0.64，第3组为1.49±0.47，第4组为1.6±0.68，p = 0.012。抗纽蛋白的光密度分别为：第1组1.34±0.78，第2组1.46±0.92，第3组1.31±0.79，对照组1.41±0.86（p = 0.875）。以抗CdtB的临界值1.56计算，各组阳性率分别为：第1组n = 10（22.7%），第2组n = 9（34.6%），第3组19（43.2%），第4组21（45.7%）（p = 0.106）。以抗纽蛋白临界值1.6计算的阳性率分别为：第1组n = 18（40.9%），第2组n = 11（42.3%），第3组15（34.1%），第4组22（47.8%）（p = 0.622）。
我们的研究结果表明，抗CdtB和抗纽蛋白无法识别IBD-IBS患者，也无法区分腹泻型肠易激综合征与健康对照。
