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Systemic interleukin-9 in inflammatory bowel disease: Association with mucosal healing in ulcerative colitis

World Journal of Gastroenterology 2017年第22期23卷 4039-4046页

作者： Malgorzata Matusiewicz Katarzyna Neubauer Iwona Bednarz-Misa Sabina Gorska Malgorzata Krzystek-Korpacka Department of Medical Biochemistry Wroclaw Medical University Department of Gastroenterology and Hepatology Wroclaw Medical University Laboratory of Medical Microbiology Ludwik Hirszfeld Institute of Immunology and Experimental TherapyPolish Academy of Sciences

AIM To evaluate circulating IL9 in inflammatory bowel disease and disease-associated anemia/cachexia and assess its potential as a mucosal healing marker.METHODS Serum IL9 as well as other cytokines(IL1β, IL6, IL13, IFNγ, TNFα, and VEGF-A) were determined in 293 individuals: 97 patients with Crohn's disease(CD) and 74 with ulcerative colitis(UC) and in 122 apparently healthy controls. The clinical activity of CD and UC was expressed in terms of the Crohn's Disease Activity Index(CDAI) and the Mayo Scoring System(MDAI), respectively, and the severity of bowel inflammation in UC patients was assessed using Mayo endoscopic score. Cytokine concentrations were measured by a flow cytometry-based method using Luminex x MAP? technology. Highsensitive C-reactive protein concentrations(hs CRP) were determined in CD and UC patients using the enhanced immunoturbidimetric method.RESULTS Systemic IL9 was significantly lower in healthy individuals [9 pg/m L(95%CI: 8.2-10)] than in patients with inflammatory bowel disease(IBD): both inactive [14.3 pg/m L(11.9-19.9)] and active [27.6 pg/m L(24.5-32), P mucosal healing(MH), IL9 had an accuracy superior to hs CRP and IL6 [97%(P < 0.0001), 67%(P = 0.071), and 55%(P = 0.525), respectively]. IL9 was significantly higher in cachectic IBD patients [30.25 pg/m L(24.4-37.5) vs 21.88 pg/m L(18-26.5), P = 0.026] and negatively correlated with hemoglobin concentrations(ρ =-0.27, P < 0.001). Multiple regression showed IL1β and IL13 to be the independent predictors of circulating IL9 in healthy individuals, IFNγ or IL6 in active and inactive UC, respectively, and IL13 and VEGF-A

关键词： Interleukin 9 mucosal 愈合 Biomarker 煽动性的肠疾病 Crohns 疾病 Ulcerative 大肠炎极度瘦弱贫血症

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Role of new endoscopic techniques in inflammatory bowel disease management: Has the change come?

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World Journal of Gastroenterology 2017年第24期23卷 4324-4329页

作者： loredana goran lucian negreanu ana maria negreanu Internal Medicine Ⅱ Gastroenterology department University Hospital Carol Davila University of Medicine

Despite significant therapeutic progress in recent years,inflammatory bowel disease(IBD),which includes Crohn’s disease and ulcerative colitis,remains a challenge regarding its pathogenesis and long-term complications.New concepts have emerged in the management of this disease,such as the"treat-totarget"concept,in which mucosal healing plays a key role in the evolution of IBD,the risk of recurrence and the need for surgery.Endoscopy is essential for the assessment of mucosal inflammation and plays a pivotal role in the analysis of mucosal healing in patients with IBD.Endoscopy is also essential in the detection of dysplasia and in the identification of the risk of colon cancer.The current surveillance strategy for dysplasia in IBD patients indicates white-light endoscopy with non-targeted biopsies.The new chromoendoscopy techniques provide substantial benefits for both clinicians and patients.Narrow-band imaging(NBI)has similar rates of dysplastic lesion detection as whitelight endoscopy,and it seems that NBI identifies more adenoma-like lesions.Because it is used instinctively by many endoscopists,the combination of these two techniques might improve the rate of dysplasia detection.Flexible spectral imaging color enhancement can help differentiate dysplastic and non-dysplastic lesions and can also predict the risk of recurrence,which allows us to modulate the treatment to gain better control of the disease.The combination of noninvasive serum and stool biomarkers with endoscopy will improve the monitoring and limit the evolution of IBD because it enables the use of a personalized approach to each patient based on that patient’s history and risk factors.

关键词： Chromoendoscopy 灵活光谱成像颜色改进煽动性的肠疾病发育异常 mucosal 愈合缩小乐队成像

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Clinical relevance of endoscopic assessment of inflammation in ulcerative colitis: Can endoscopic evaluation predict outcomes?

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World Journal of Gastroenterology 2016年第42期22卷 9324-9332页

作者： Noor Mohammed Venkataraman Subramanian Leeds Institute of Biomedical and Clinical Sciences St James University Hospital University of Leeds Leeds LS2 9JT United Kingdom Department of Gastroenterology Centre for Digestive Diseases St James University Hospital Leeds Teaching Hospital NHS Trust Leeds LS9 7TF United Kingdom

Ulcerative colitis(UC) is a chronic inflammatory bowel condition characterised by a relapsing and remitting course. Symptom control has been the traditional mainstay of medical treatment. It is well known that histological inflammatory activity persists despite adequate symptom control and absence of endoscopic inflammation. Current evidence suggests that presence of histological inflammation poses a greater risk of disease relapse and subsequent colorectal cancer risk. New endoscopic technologies hold promise for developing endoscopic markers of mucosal inflammation. Achieving endoscopic and histological remission appears be the future aim of medical treatments for UC. This review article aims to evaluate the use of endoscopy as a tool in assessment of mucosal inflammation UC and its correlation with disease outcomes.

关键词： Ulcerative 大肠炎发炎内视镜检查法疾病活动索引 mucosal 愈合

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Trefoil factor-3 is not a useful marker of mucosal healing in Crohn's disease treated with anti-TNF-α antibodies

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World Journal of Gastroenterology 2017年第1期23卷 135-140页

作者： Piotr Eder Kamila Stawczyk-Eder Katarzyna Korybalska Natasza Czepulis Joanna Luczak Liliana Lykowska-Szuber Iwona Krela-Kazmierczak Krzysztof Linke Janusz Witowski Department of Gastroenterology Human Nutrition and Internal DiseasesPoznan University of Medical Sciences Department of Pathophysiology Poznan University of Medical Sciences

AIM To evaluate whether repeated serum measurements of trefoil factor-3(TFF-3)can reliably reflect mucosal healing(MH)in Crohn’s disease(CD)patients treated with anti-tumor necrosis factor-α(anti-TNF-α)antibodies.METHODS Serum TFF-3 was measured before and after antiTNF-αinduction therapy in 30 CD patients.The results were related to clinical,biochemical and endoscopic parameters.MH was defined as a≥50%decrease in Simple Endoscopic Score for Crohn’s disease(SES-CD).RESULTS SES-CD correlated significantly with CD clinical activity and several standard biochemical parameters(albumin,leukocyte and platelet counts,C-reactive protein,erythrocyte sedimentation rate,fibrinogen).In contrast,SES-CD did not correlate with TFF-3(P=0.54).Moreover,TFF-3 levels did not change significantly after therapy irrespectively of whether the patients achieved MH or not.Likewise,TFF-3 did not correlate with changes in fecal calprotectin,which has been proposed as another biochemical marker of mucosal damage in CD.CONCLUSION Serum TFF-3 is not a convenient and reliable surrogate marker of MH during therapy with TNF-αantagonists in CD.

关键词： Adalimumab Crohn’ s 疾病 Infliximab mucosal 愈合翘摇因素

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