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JGH: 前列腺素E主要尿代谢物可以评估溃疡性结肠炎缓解期患者的黏膜愈合情况

2022-05-16 xuyihan MedSci原创

每年大约有3万新增的确诊为克罗恩病和溃疡性结肠炎的患者;溃疡性结肠炎可以发生于任何年龄阶段;平均来说,溃疡型结肠炎好发于35岁左右。

溃疡性结肠炎 (UC) 是最常见的炎症性肠病 (IBD),近年来在欧洲和北美以及亚洲国家的发病率分别为每 10 万人505人和286人。UC 是一种特发性疾病,其特征是大肠出现溃疡由此导致生活质量下降。此外,UC 中反复出现的炎症可导致结肠癌的发生。研究显示使用内窥镜检查评估的粘膜愈合 (MH) 被称为深度缓解,并且与较少的复发和良好的预后相关。梅奥内窥镜评分 (MES) 1 的患者比 MES 0 的患者具有更高的复发风险。

临床缓解期的 UC 患者需要定期进行结肠镜检查,但由于检查时的疼痛和侵入性,不能被很好的广泛接受。前列腺素E主要尿代谢物 (PGE-MUM) 是作为前列腺素E2 (PGE2) 的代谢物会从尿中排出。在肠粘膜深部发炎的情况下,它的水平会增加。据报道,PGE-MUM 水平与 UC 中结肠炎症的程度有关。在这项研究中,研究人员评估了 PGE-MUM 在诊断 UC 的内镜、组织学和组织内镜黏膜缓解方面的有效性,并与粪便检测进行优劣性比较。

 

这项前瞻性研究于 2017年8月至2021年1月在韩国集庆大学医院进行。纳入计划接受结肠镜检查的处于疾病缓解期的UC患者。然后分析了患者PGE-MUM水平与内镜缓解 (ER)、组织学缓解 (HR) 和黏膜完全愈合 (CMH,定义为组织内镜缓解) 之间的关系。同时研究人员还比较了PGE-MUM、粪便钙卫蛋白 (FC) 和粪便免疫化学测试 (FIT) 之间的受试者工作特征曲线的曲线下面积 (AUC)。

 

本项研究总共分析了128 名患者。PGE-MUM 在内镜缓解患者与非内镜缓解患者中存在明显差异(14.5 VS 16.7,P=0.028)、而组织学缓解患者的PGE-MUM水平与非组织学缓解患者相比也更低(14.2 VS 17.4,P=0.004),和黏膜完全愈合患者相比,非黏膜完全愈合患者的PGE-MUM更高(14.3 VS 16.7,P=0.021 )。PGE-MUM、FC 的 AUC 和 ER、HR 或 CMH 的 FIT 之间没有显着差异。

图:前列腺素E主要尿代谢物的表达水平差异

 

本项研究证实即使在临床缓解期间,无论疾病表型如何,PGE-MUM水平也可以确定UC患者中的黏膜完全愈合程度,表明其在无创监测方面的临床益处。

 

 

原始出处:

Toshiyuki Sakurai. Et al. Prostaglandin E-major urinary metabolite diagnoses mucosal healing in patients with ulcerative colitis in remission phase. Journal of Gastroenterology and Hepatology.2022.

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    2023-01-23 nymo
  6. [GetPortalCommentsPageByObjectIdResponse(id=1744875, encodeId=0ca81e44875bb, content=<a href='/topic/show?id=37c3325555a' target=_blank style='color:#2F92EE;'>#前列腺素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32555, encryptionId=37c3325555a, topicName=前列腺素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6e7035453721, createdName=makuansheng, createdTime=Wed Apr 05 08:05:13 CST 2023, time=2023-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1994926, encodeId=fdea1994926a8, content=<a href='/topic/show?id=bd3f10325926' target=_blank style='color:#2F92EE;'>#黏膜愈合#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103259, encryptionId=bd3f10325926, topicName=黏膜愈合)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Fri Jan 06 13:05:13 CST 2023, time=2023-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660027, encodeId=21c6166002ea1, content=<a href='/topic/show?id=24e82545262' target=_blank style='color:#2F92EE;'>#代谢物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25452, encryptionId=24e82545262, topicName=代谢物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c1225086772, createdName=旅苦化文_216, createdTime=Fri Jul 08 22:05:13 CST 2022, time=2022-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1985484, encodeId=7cbc19854846a, content=<a href='/topic/show?id=165de9216c8' target=_blank style='color:#2F92EE;'>#缓解期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79216, encryptionId=165de9216c8, topicName=缓解期)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/E33DC517C2EC449E463E3D01D81745BA/100, createdBy=75e12500157, createdName=ms1756883563247400, createdTime=Sat Aug 27 23:05:13 CST 2022, time=2022-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1695280, encodeId=0e331695280d4, content=<a href='/topic/show?id=c76e6645438' target=_blank style='color:#2F92EE;'>#溃疡性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66454, encryptionId=c76e6645438, topicName=溃疡性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=787129789891, createdName=nymo, createdTime=Mon Jan 23 01:05:13 CST 2023, time=2023-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520101, encodeId=b3191520101b9, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Tue May 17 06:05:13 CST 2022, time=2022-05-17, status=1, ipAttribution=)]
    2022-05-17 snowpeakxu

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