Histologic markers of inflammation in patients with ulcerative colitis in clinical remission.
Histologic markers of inflammation in patients with ulcerative colitis in clinical remission.
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DOI：
10.1016/j.cgh.2013.02.030
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发表时间：
2013-08
影响因子：
12.6
通讯作者：
Moss, Alan C.
中科院分区：
文献类型：
--
作者：
Rosenberg, Laura;Nanda, Kavinderjit S.;Zenlea, Talia;Gifford, Anne;Lawlor, Garrett O.;Falchuk, Kenneth R.;Wolf, Jacqueline L.;Cheifetz, Adam S.;Goldsmith, Jeffrey D.;Moss, Alan C.
基于组织学分析的粘膜愈合是溃疡性结肠炎 (UC) 患者维持治疗的终点。关于这些患者炎症的组织学体征与内窥镜和外周血炎症测量值如何相关的数据很少。我们研究了临床缓解期 UC 患者炎症的组织学特征模式，并将其与炎症的内镜和生化指标相关联。我们对 103 名临床缓解的 UC 患者进行了一项前瞻性观察研究，这些患者在接受美沙拉嗪或硫嘌呤维持治疗的同时接受监测结肠镜检查；从 708 个结肠段收集了 2674 个活检组织。每个结肠段均根据 Mayo 内窥镜评分和 Geboes 组织学评分 (0-5.4) 进行评估。测量外周血样本中的生物标志物。 54% 接受维持治疗的患者发现炎症的组织学特征；根据组织学评分，37% 的人至少患有中度炎症。在 52 名内镜检查仅显示左侧结肠炎的患者中，34% 的近端结肠有炎症的组织学特征。组织学评分与每节段炎症的内镜评分相关（Spearman’s ρ=0.65；P<.001）。组织学评分 > 3.1 的患者的 C 反应蛋白 (CRP) 平均水平显着高于评分 < 3.1 的患者。治疗组之间组织学评分>3.1的患者百分比没有差异。 UC 临床缓解的患者仍然经常具有炎症的组织学特征，这与内镜下的表现相关。根据组织学分级（评分 >3.1），具有至少中度炎症水平的患者具有较高的血清 CRP 水平，这可以用作组织学炎症的替代标志物。
Mucosal healing, based on histologic analysis, is an endpoint of maintenance therapy for patients with ulcerative colitis (UC). There are few data on how histologic signs of inflammation correlate with endoscopic and peripheral blood measures of inflammation in these patients. We investigated patterns of histologic features of inflammation in patients with UC in clinical remission, and correlated these with endoscopic and biochemical measures of inflammation. We performed a prospective observational study of 103 patients with UC in clinical remission undergoing surveillance colonoscopy while receiving maintenance therapy with mesalamine or thiopurines; 2674 biopsies were collected from 708 colonic segments. Each colonic segment was evaluated based on the Mayo endoscopic sub-score and the Geboes histology score (0–5.4). Biomarkers were measured in peripheral blood samples. Histologic features of inflammation were found in 54% of patients receiving maintenance therapy; 37% had at least moderate inflammation, based on histology scores. Of the 52 patients with endoscopic evidence only of left-sided colitis, 34% had histologic features of inflammation in their proximal colon. Histology scores correlated with endoscopic scores for per-segment inflammation (Spearman’s ρ=0.65; P<.001). Patients with histology scores >3.1 had a significantly higher mean level of C-reactive protein (CRP) than those with scores <3.1. There were no differences among treatment groups in percentages of patients with histologic scores >3.1. Patients in clinical remission from UC still frequently have histologic features of inflammation, which correlate with endoscopic appearance. Patients with at least moderate levels of inflammation, based on histologic grading (score >3.1), have higher serum levels of CRP, which could be used as a surrogate marker of histologic inflammation.
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影响因子：
8
作者：
Peyrin-Biroulet, Laurent;Ferrante, Marc;Sturm, Andreas
通讯作者：
Sturm, Andreas
影响因子：
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作者：
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DOI：
10.1111/j.1440-1746.2008.05413.x
发表时间：
2008-12-01
影响因子：
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作者：
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通讯作者：
Watanabe, Sumio
影响因子：
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作者：
Moss, Alan C.;Chaudhary, Nabeel;Cheifetz, Adam S.
通讯作者：
Cheifetz, Adam S.