Beattie R M, Goulding N J, Walker-Smith J A, MacDonald T T
Academic department of Paediatric Gastroenterology, St Bartholomew's Hospital, London, UK.
Aliment Pharmacol Ther. 1995 Oct;9(5):541-5. doi: 10.1111/j.1365-2036.1995.tb00418.x.
Corticosteroids are widely used to treat children with inflammatory bowel disease although the response is variable, side-effects are common, and many patients develop a partial or complete steroid resistance. The mechanism underlying these phenomena are unclear. Corticosteroids mediate some of their actions through lipocortin-1, and the induction of autoantibodies to lipocortin has been proposed as a possible mechanism by which steroid efficacy is suboptimal in vivo.
We have measured serum lipocortin-1 antibody concentration by ELISA in 38 children with Crohn's disease, 12 with ulcerative colitis and in 15 controls.
IgG and IgA anti-lipocortin-1 antibody levels were higher in the Crohn's group than in the ulcerative colitis or control groups. Elevated concentrations did not relate to disease activity, history of steroid therapy or steroid-responsiveness. Lipocortin IgM antibody status was similar in all three groups.
It is therefore unlikely that serum antibodies to lipocortin-1 have a role in the development of steroid-resistance in children with inflammatory bowel disease.
皮质类固醇被广泛用于治疗患有炎症性肠病的儿童,尽管疗效因人而异,副作用常见,且许多患者会出现部分或完全的类固醇抵抗。这些现象背后的机制尚不清楚。皮质类固醇通过脂皮质蛋白-1介导其部分作用,有人提出诱导针对脂皮质蛋白的自身抗体是体内类固醇疗效欠佳的一种可能机制。
我们通过酶联免疫吸附测定法(ELISA)测量了38例克罗恩病患儿、12例溃疡性结肠炎患儿及15名对照者血清中脂皮质蛋白-1抗体的浓度。
克罗恩病组的IgG和IgA抗脂皮质蛋白-1抗体水平高于溃疡性结肠炎组或对照组。浓度升高与疾病活动度、类固醇治疗史或类固醇反应性无关。三组中脂皮质蛋白IgM抗体状态相似。
因此,针对脂皮质蛋白-1的血清抗体不太可能在炎症性肠病患儿的类固醇抵抗发展中起作用。