Kruis W, Schussler P, Weinzierl M, Galanos C, Eisenburg J
Dig Dis Sci. 1984 Jun;29(6):502-7. doi: 10.1007/BF01296269.
Lipid A is a component common to endotoxins of gram-negative bacteria. It has been suggested that the gut wall of patients with inflammatory bowel disease is more permeable to luminal bacterial macromolecules which may stimulate the gut-associated lymphoid tissue. We therefore investigated 40 patients with Crohn's disease (CD) and 23 patients with ulcerative colitis (UC) with respect to their lipid A antibody titers and presence of endotoxins (Limulus test). Both tests were performed simultaneously using peripheral venous blood. Systemic endotoxin was demonstrated in only two of the patients. The lipid A antibody titers in the CD patients were significantly higher than either in patients with UC or in 42 healthy controls. Lipid A titers of patients with UC did not differ from those of controls. Titers of lipid A were significantly higher in patients with active Crohn's disease than in patients with inactive disease. It is concluded that systemic endotoxemia occurs rarely in patients with inflammatory bowel disease; however, despite this virtual absence of endotoxins in their peripheral blood, patients with CD show an increase in antibody formation against lipid A. This is suggestive of an altered immunologic reactivity against endotoxins in patients with CD and may be relevant to the pathogenesis of this disease.
脂多糖A是革兰氏阴性菌内毒素的共同组成成分。有人提出，炎症性肠病患者的肠壁对管腔内细菌大分子的通透性更高，这些大分子可能会刺激肠道相关淋巴组织。因此，我们针对40例克罗恩病（CD）患者和23例溃疡性结肠炎（UC）患者，检测了他们的脂多糖A抗体滴度以及内毒素的存在情况（鲎试剂检测）。两项检测均使用外周静脉血同时进行。仅在两名患者中检测到全身性内毒素。CD患者的脂多糖A抗体滴度显著高于UC患者或42名健康对照者。UC患者的脂多糖A滴度与对照组无差异。活动期克罗恩病患者的脂多糖A滴度显著高于非活动期患者。得出的结论是，炎症性肠病患者很少发生全身性内毒素血症；然而，尽管外周血中几乎不存在内毒素，但CD患者针对脂多糖A的抗体形成增加。这表明CD患者对内毒素的免疫反应性发生了改变，可能与该疾病的发病机制有关。
