Moriya Kei, Nagamatsu Shinsaku, Nishio Yuya, Komeda Yusuke, Kikukawa Shoma, Matsuura Kyohei, Matsuo Hideki, Uejima Masakazu, Kitagawa Takamichi, Nakamura Fumihiko
Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 630-8581, Japan.
Department of Endocrinology and Metabolism, Nara Prefecture General Medical Center, Nara 630-8581, Japan.
J Clin Med. 2025 Jan 28;14(3):874. doi: 10.3390/jcm14030874.
Numerous patients with ulcerative colitis (UC) become mentally unstable after experiencing a long-standing, physically painful life, and their long-term prognosis is poorer than that of those who are mentally stable. The current study aimed to evaluate serum biomarkers for predicting mental instability, which is challenging to objectively quantify. In total, 29 refractory UC patients newly treated with filgotinib underwent measurements of blood parameters associated with depression and a quantitative assessment of quality of life using the Inflammatory Bowel Disease Questionnaire (IBDQ) before and after treatment initiation with a 12-week interval. The data collected were examined in relation to each other. The induction of remission treatment with filgotinib resulted in a clinical response rate of 89.7% and a clinical remission rate of 86.2%, with all eight extraintestinal manifestations resolved. No adverse events were observed. The serum zinc, high-density lipoprotein cholesterol, mature brain-derived neurotrophic factor (BDNF) concentrations, and the IBDQ psychiatric subscores increased significantly after treatment ( < 0.05). Among these parameters, the mature-BDNF concentration and the IBDQ psychiatric subscore had the strongest positive correlation (R = 0.29, = 0.08). Based on the logistic regression analysis, the mature-BDNF concentration (cutoff value: 20.5 ng/mL) had a sensitivity of 68.2%, specificity of 64.7%, and area under the curve of 0.67 for predicting psychiatric remission (subscore > 42.5) ( = 0.04). While it is not easy to objectively predict the degree of psychiatric instability in patients with refractory UC, serum mature-BDNF levels can be a useful biomarker.
许多溃疡性结肠炎（UC）患者在经历长期身体疼痛的生活后会出现精神不稳定，其长期预后比精神稳定的患者更差。目前的研究旨在评估用于预测精神不稳定的血清生物标志物，而精神不稳定难以客观量化。总共29例新接受非戈替尼治疗的难治性UC患者在开始治疗前和治疗12周后，间隔12周进行了与抑郁相关的血液参数测量，并使用炎症性肠病问卷（IBDQ）对生活质量进行了定量评估。对收集到的数据进行了相互检查。非戈替尼诱导缓解治疗的临床缓解率为89.7%，临床缓解率为86.2%，所有8例肠外表现均得到缓解。未观察到不良事件。治疗后血清锌、高密度脂蛋白胆固醇、成熟脑源性神经营养因子（BDNF）浓度和IBDQ精神亚评分显著增加（<0.05）。在这些参数中，成熟BDNF浓度与IBDQ精神亚评分的正相关性最强（R=0.29，=0.08）。基于逻辑回归分析，成熟BDNF浓度（临界值：20.5 ng/mL）预测精神缓解（亚评分>42.5）的敏感性为68.2%，特异性为64.7%，曲线下面积为0.67（=0.04）。虽然客观预测难治性UC患者精神不稳定的程度并不容易，但血清成熟BDNF水平可能是一种有用的生物标志物。
