Buldukoglu Osman Cagin, Ocal Serkan, Atar Galip Egemen, Kaya Besir, Isik Muhammet Devran, Aydin Tigli Gul, Akca Serdar, Harmandar Ferda Akbay, Cekin Yesim, Cekin Ayhan Hilmi
Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Türkiye.
Department of Medical Microbiology, Antalya Training and Research Hospital, Antalya, Türkiye.
Turk J Gastroenterol. 2025 May 20;36(9):556-562. doi: 10.5152/tjg.2025.24726.
Background/Aims: Crohn's disease (CD) is an inflammatory, progressive disorder requiring monitoring of treatment response and disease course. Gasdermin D (GSDMD), a protein belonging to the gasdermin protein family, plays a role in inflammatory cell death, and activation of GSDMD has been shown to be a component of the pathogenesis of inflammatory bowel disease. Considering the role that GSDMD plays in inflammation, it was hypothesized that disease activity in CD may be correlated with serum GSDMD levels. The aim of this study was to assess the strength of GSDMD in predicting clinical disease activity in patients with CD in a prompt and easy manner. Materials and Methods: This cross-sectional study was conducted over a span of 22 months from September 2022 to June 2024. A total of 61 patients with CD were included in the study. Demographic data, disease- and treatment-related data, and laboratory workups of the patients were recorded and analyzed. Results: Gasdermin D levels were statistically significant in their correlation with the Harvey-Bradshaw Index (HBI) scores of the study population (P = .019). A threshold value of 5 ng/mL for GSDMD had a sensitivity of 84.6% and a specificity of 91.7% in differentiating patients with remission or mild disease from those with moderate or severe disease, according to HBI. Conclusion: This pioneering study revealed that serum GSDMD can be used as a biomarker to assess clinical disease activity in patients with CD. Future studies incorporating colonoscopic evaluation into the equation will provide more insight into the use of this protein as a surrogate marker of disease progression in CD.
背景/目的:克罗恩病(CD)是一种炎症性、进行性疾病,需要监测治疗反应和疾病进程。Gasdermin D(GSDMD)是一种属于Gasdermin蛋白家族的蛋白质,在炎症性细胞死亡中起作用,并且GSDMD的激活已被证明是炎症性肠病发病机制的一个组成部分。考虑到GSDMD在炎症中所起的作用,推测CD的疾病活动可能与血清GSDMD水平相关。本研究的目的是以快速简便的方式评估GSDMD在预测CD患者临床疾病活动中的作用强度。材料与方法:本横断面研究于2022年9月至2024年6月进行,为期22个月。共有61例CD患者纳入研究。记录并分析患者的人口统计学数据、疾病和治疗相关数据以及实验室检查结果。结果:Gasdermin D水平与研究人群的哈维-布拉德肖指数(HBI)评分具有统计学意义的相关性(P = 0.019)。根据HBI,GSDMD的阈值为5 ng/mL时,区分缓解或轻度疾病患者与中度或重度疾病患者的敏感性为84.6%,特异性为91.7%。结论:这项开创性研究表明,血清GSDMD可作为评估CD患者临床疾病活动的生物标志物。未来将结肠镜检查评估纳入考量的研究将为该蛋白作为CD疾病进展替代标志物的应用提供更多见解。