| The clinical significance of autoantibodies profile in inflammatory bowel disease BackgroundThe inflammatory bowel disease (IBD) are a heterogeneous group of inflammatory disorders of the gastrointestinal tract, which etiology is unknown. The group is primarily subdivided into ulcerative colitis (UC) and Crohn's disease (CD). These diseases are characterized by abdominal pain, diarrhea, fistula, perianal lesions and various degrees of systemic symptoms. The diagnosis of IBD relies on clinical manifestation, Colonoscopy, X-ray and biopsy. The clinical significance of anti-saccharomyces cerevisiae antibody (ASCA), anti-neutrophil cytoplasmic antibody(ANCA), anti-intestinal goblet cell antibody(GBA) and anti-pancreatic antibody(PAB) for the diagnosis and differentiation of IBD patients has been widely reported.ObjectiveTo evaluate the clinical significance of combined measurement of ASCA, ANCA, GBA and PAB for the diagnosis and differentiation of IBD patients.MethodsA total of 159 patients with IBD (97 UC,62 CD),167 patients with other non-IBD gastrointestinal conditions (NIBDC) and 25 healthy controls (HC) were recruited in our research. ASCA and ANCA were detected by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence assay, respectively.Meanwhile, GBA and PAB were ditected by indirect immunofluorescence assay in 20 patients with UC,20 patients with CD,20 patients with other intestinal disease and 10 health donars.ResultsThe prevalence of ASCA-IgA or IgG in CD group, UC group, NIBDC and HC were 43.5%,14.4%,29.3%, and 0, respectively. The prevalence of ASCA-IgA or IgG in CD group were higher than those in other groups (x2=16.76, x2=4.12; P＜0.001,P=0.042). The prevalence of ANCA in CD group, UC group, NIBDC and HC were 8.1%,56.7%, 4.8%, and 0, respectively. The prevalence of ANCA in UC group was much higher than in other groups (x2=38.08, x2=90.47; P＜0.001, P＜0.001). The sensitivity, specificity and positive predictive value (PPV) in ASCA+/ANCA-were 40.3%,93.8% and 80.6%, respectively, and in ANCA+/ASCA-were 48.5%,98.4% and 97.9%, respectively. The positive pattern of ASCA in CD group was correlated with surgery (P=0.03). The prevalence of ASCA-IgA in CD is higher than ASCA-IgG, but there is no statistically significant difference (P=0.481). The prevalence of GBA in patients with UC, CD, other intestinal disease and control group were 30%,65%,10% and 0% respectively. The prevalence in CD group was significantly higher than in other two control groups(P <0.05), but there were no significant difference between UC and CD(P>0.05). The sensitivity, specificity,positive and negative predictive value of combination of GBA+/ANCA- in the diagnosis of CD were 45%,95%,90% and 63.3%, respectively.ConclusionASCA, ANCA, GBA and PAB testing are not sensitive enough for diagnosing CD and UC, but their combination assays are specific for differentiation between CD and UC. Combined testing of ASCA-IgA with IgG can improve the sensitivity in screening CD patients. The positive pattern of ASCA in Chinese CD group was correlated with surgery. BackgroundUlcerative colitis (UC) is a non-specific chronic colitis primarily affecting the colonic mucosa; the extent and severity of colon involvement are variable. In its most limited form it may he restricted to the distal rectum, while in its most extended form the entire colon is involved. Assessment of disease activity in ulcerative colitis, which mainly relies on colonoscopy and biopsy, will be helpful for the selection of reasonable treatment. But because of the cost-effectiveness and the pain it may cause, it's not suitable for every patient. Ttriggering receptor on myeloid cells-1(TREM-1) is a novel marker of early inflammatory response. It's an activation receptor and belongs to immunoglobulin superfamily, selectively expressed on neutrophils and monocytes.ObjectiveFind out the relationship between TREM-1 and disease activity, and discovery the role of TREM-1 in the pathogenesis of UC.MethodsWe established the method to detect the expression of TREM-1 mRNA on peripheral blood mononuclear cells (PBMCs) by real-time quantitative polymerase chain reaction (FQ-RT-PCR) and detected the expression of TREM-1 mRNA in UC patients. We compared the expression of TREM-1 mRNA in UC patients with variety disease activity and heath controls. ResultsExpressions of TREM-1 mRNA in active UC patients (4.19±1.86) were higher than those of relived UC patients (5.29±1.71,P=0.002) and healthy controls (5.19±1.04,P =0.03), and there is no difference between expressions of TREM-1 mRNA in relieved UC patients and in healthy controls(P>0.05). In active UC patients, expression of TREM-1 mRNA is correlated with ESR (P=0.003), but has no correlation with CRP (P=0.055). ConclusionThe mRNA expression of TREM-1 was signifieantly elevated in UC, which suggests that TREM-1 might be involved in the pathogenesis of UC. In active UC patients, expression of TREM-1 mRNA is correlated with ESR, but has no correlation with CRP. |
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