Joint Extraintestinal Manifestations in Ulcerative Colitis
Joint Extraintestinal Manifestations in Ulcerative Colitis
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DOI：
10.1159/000233289
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发表时间：
2009-01-01
影响因子：
2.3
通讯作者：
Rassokhina, O. A.
中科院分区：
文献类型：
--
作者：
Dorofeyev, A. E.;Vasilenko, I. V.;Rassokhina, O. A.
肠外表现（EIM）经常发生在溃疡性结肠炎（UC）患者。EIM改变UC的自然病程，降低这些患者的生活质量。本研究的目的是分析UC合并关节EIM患者的临床和实验室结果。对319例UC患者进行了检查。其中远端UC 131例（41.1%），左侧UC 102例（32.0%），全结肠炎86例（26.9%）。95例（29.8%）UC患者有关节EIM。关节炎与广泛形式的UC相关，更常见于左侧UC和全结肠炎患者。关节痛是远端UC患者关节EIM的常见症状。分析UC患者的结肠微生物病和粘膜屏障。我们研究了细胞因子在特殊情况下的变化。所有UC患者均出现菌群失调，双歧杆菌、乳酸菌和大肠杆菌数量减少，兼性菌群数量增加。同时，在UC患者中观察到兼性菌群与关节炎的关系。在这些患者中，在粪便培养中更常发现葡萄球菌、克雷伯氏菌和变形杆菌。这些关联与结肠细胞黏液受体成熟度的改变有关，这是一种凝集素染色强度降低的情况。所有UC患者均存在促炎细胞因子增加和抗炎细胞因子减少的细胞因子失衡。分析UC合并关节EIM患者的特权细胞因子谱变化。观察到关节EIM患者血浆中IL-1和TNF的最大升高和IL-10的最大降低。版权所有(C) 2009 S. Karger AG，巴塞尔
An extraintestinal manifestation (EIM) very often occurs in ulcerative colitis (UC) patients. EIM modifies the natural course of UC and decreases the quality of life in these patients. The aim of this study was to analyze clinical and laboratory findings in UC patients with joint EIM. 319 UC patients were examined. Among them were 131 (41.1%) patients with distal UC, 102 (32.0%) suffered from left-sided UC and 86 (26.9%) had pancolitis. 95 (29.8%) UC patients had joint EIM. Arthritis correlated with extensive forms of UC and was more often determined in patients with left-sided UC and pancolitis. Arthralgia was a prevalent symptom of joint EIM in patients with distal UC. Colon microbiocenosis and the mucosal barrier in UC patients were analyzed. The cytokine status with privileged cytokine profile changes was investigated. In all UC patients, dysbiosis with a decreasing quantity of bifidobacteria, lactobacilli and Escherichia coli was found, but an increase of facultative flora was also found. At the same time, an association of facultative flora in UC patients with arthritis was observed. In these patients, Staphylococcus, Klebsiella and Proteus were found more often in stool cultures. These associations correlated with a modification of the colonocytes' cell receptor maturity of mucus, a condition with a decreased staining intensity by lectins. A cytokine imbalance with an increase of proinflammatory and a decrease of anti-inflammatory cytokines was found in all UC patients. The privileged cytokine profile changes in UC patients with joint EIM were analyzed. Maximal increases of IL-1 and TNF with decreases of IL-10 in plasma in patients with joint EIM were observed. Copyright (C) 2009 S. Karger AG, Basel