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Gut barrier failure biomarkers are associated with poor disease outcome in patients with primary sclerosing cholangitis

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World Journal of Gastroenterology 2017年第29期23卷 5412-5421页

作者： Tamas Tornai Eszter Palyu Zsuzsanna Vitalis Istvan Tornai David Tornai Peter Antal-Szalmas Gary L Norman Zakera Shums Gabor Veres Antal Dezsofi Gabriella Par Alajos Par Peter Orosz Ferenc Szalay Peter Laszlo Lakatos Maria Papp Institute of Internal Medicine Department of Gastroenterology University of Debrecen Faculty of Medicine Department of Laboratory Medicine University of Debrecen Faculty of Medicine Debrecen Inova Diagnostics Inc.San Diego 1^st Department of Pediatrics Semmelweis University 1^st Department of Medicine University of Pecs Gastroenterology Department of Medicine Borsod-Abauj Zemplen County Hospital 1^st Department of Medicine Semmelweis University

To assess the prevalence of a panel of serologic markers that reflect gut barrier dysfunction in a mixed cohort of pediatric and adult primary sclerosing cholangitis (PSC) patients. METHODSSera of 67 PSC patients [median age (range): 32 (5-79) years, concomitant IBD: 67% and cirrhosis: 20%] were assayed for the presence of antibodies against to F-actin (AAA IgA/IgG) and gliadin (AGA IgA/IgG)] and for serum level of intestinal fatty acid-binding protein (I-FABP) by ELISA. Markers of lipopolysaccharide (LPS) exposure [LPS binding protein (LBP)] and various anti-microbial antibodies [anti-OMP Plus IgA and endotoxin core IgA antibody (EndoCAb)] were also determined. Poor disease outcome was defined as orthotopic liver transplantation and/or liver-related death during the follow-up [median: 99 (14-106) mo]. One hundred and fifty-three healthy subjects (HCONT) and 172 ulcerative colitis (UC) patients were the controls. RESULTSA total of 28.4%, 28.0%, 9% and 20.9% of PSC patients were positive for AAA IgA, AAA IgG, AGA IgA and AGA IgG, respectively. Frequencies of AAA IgA and AAA IgG (P AAA IgA posvsneg: 365 vs 166 pg/mL, P = 0.011), but not with serum LBP level. CONCLUSIONPresence of IgA type AAA identified PSC patients with progressive disease. Moreover, it is associated with enhanced mucosal immune response to various micr

关键词： Primary sclerosing cholangitis Gut barrier dysfunction intestinal fatty acid-binding protein Anti-F-actin antibody Anti-gliadin antibody

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