Nakanishi Risa, Kuwada Takeshi, Shiokawa Masahiro, Nishikawa Yoshihiro, Ota Sakiko, Yamazaki Hajime, Yanaidani Takafumi, Sawada Kenji, Hirata Ayako, Yasuda Muneji, Takimoto Ikuhisa, Chikugo Koki, Yokode Masataka, Muramoto Yuya, Matsumoto Shimpei, Matsumori Tomoaki, Uza Norimitsu, Chiba Tsutomu, Seno Hiroshi
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Inflamm Bowel Dis. 2025 Mar 3;31(3):777-785. doi: 10.1093/ibd/izae263.
Pouchitis is the most common complication of restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC). We previously reported the presence of anti-integrin αvβ6 antibodies in the serum of patients with UC. This study investigated the association between anti-integrin αvβ6 antibodies and the development of pouchitis in patients with UC.
Serum levels of anti-integrin αvβ6 antibodies were measured by enzyme-linked immunosorbent assay in 16 patients with UC who underwent RPC with IPAA. Integrin αvβ6 expression in the colonic, terminal ileal, and pouch epithelium was examined using immunohistochemistry and western blot analysis.
Anti-integrin αvβ6 antibody levels in patients with UC were significantly decreased at 3, 9, and 12 months after RPC (P < .05). However, in patients who developed pouchitis, antibody levels remained high. The antibody levels at the time of RPC were significantly higher in patients who developed pouchitis compared to those who did not. Kaplan-Meier analysis revealed a significantly higher incidence of pouchitis in patients with antibody levels above the cutoff at the time of RPC. Although integrin αvβ6 was not expressed in the terminal ileal epithelium at the time of RPC, expression became positive in the pouch epithelium of patients with pouchitis.
The anti-integrin αvβ6 antibody levels in patients with UC were decreased after RPC but remained high in patients who developed pouchitis. The antibody levels at the time of RPC may serve as a potential prognostic biomarker for predicting the risk of pouchitis in patients with UC.
在溃疡性结肠炎（UC）患者中，袋炎是回肠袋肛管吻合术（IPAA）行结直肠切除术后最常见的并发症。我们之前报道过UC患者血清中存在抗整合素αvβ6抗体。本研究调查了抗整合素αvβ6抗体与UC患者袋炎发生之间的关联。
采用酶联免疫吸附测定法检测16例行IPAA的RPC的UC患者血清中抗整合素αvβ6抗体水平。采用免疫组织化学和蛋白质印迹分析检测结肠、回肠末端和袋状上皮中整合素αvβ6的表达。
UC患者抗整合素αvβ6抗体水平在RPC术后3个月、9个月和12个月时显著降低（P < 0.05）。然而，发生袋炎的患者抗体水平仍较高。与未发生袋炎的患者相比，发生袋炎的患者RPC时的抗体水平显著更高。Kaplan-Meier分析显示，RPC时抗体水平高于临界值的患者袋炎发生率显著更高。尽管RPC时整合素αvβ6在回肠末端上皮中未表达，但在发生袋炎的患者袋状上皮中表达变为阳性。
UC患者抗整合素αvβ6抗体水平在RPC后降低，但发生袋炎的患者仍较高。RPC时的抗体水平可能作为预测UC患者袋炎风险的潜在预后生物标志物。
