Current Trends in IBD-Development of Mucosal-Based Biomarkers and a Novel Minimally Invasive Recoverable Sampling System.
Current Trends in IBD-Development of Mucosal-Based Biomarkers and a Novel Minimally Invasive Recoverable Sampling System.
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IBD 的当前趋势 - 粘膜生物标志物的开发和新型微创可恢复采样系统。
DOI：
10.1093/ibd/izab179
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发表时间：
2021
影响因子：
4.9
通讯作者：
Sands,BruceE
中科院分区：
文献类型：
--
作者：
Yau,YunkiY;Wasinger,ValerieC;Hirten,RobertP;Chuang,Emil;Huntsman,Merodean;Stylli,Jack;Shimizu,Jeff;Yajnik,Vijay;Smith,Jeffrey;Lee,ShaoyingN;Singh,Sharat;Wahl,Christopher;Leong,RupertW;Sands,BruceE
尽管炎症性肠病（IBD）治疗的最新进展，但可用于帮助疾病管理的诊断工具的进展有限。越来越多的证据表明，在IBD患者的粘膜界面存在重要的宿主-微生物相互作用，其调节炎症反应。此外，粘膜完整性及其破坏的重要性似乎是重要的病理生理和疾病的延续。表征这种界面的能力可以为疾病监测和新治疗靶点的识别提供有价值的信息。内窥镜检查仍然是疾病监测的主要工具，粘膜愈合是IBD治疗的主要治疗目标。然而，建立粘膜愈合需要重复的内窥镜手术，并且内窥镜检查受到诸如侵入性、成本和不良事件风险等因素的限制。此外，使用肠道准备进行结肠镜检查会改变粘液层，从而干扰宿主-微生物相互作用的评价。粪便采样也可能不准确，因为它反映了代谢物和蛋白质的最终状态，没有考虑到在通过结肠的过程中细菌蛋白酶和其他酶对目标底物的降解或改变。一种称为可回收采样系统（RSS）的新型采样胶囊正在开发中，作为结肠镜检查的补充工具。RSS预期作为一个平台，用于非侵入性自主采样、保存、处理和储存胃肠液中发现的感兴趣分析物。胶囊腔室中含有一种专有的防腐剂，可稳定DNA和蛋白质，用于离体微生物组学和代谢组学分析。已确定SPP 24和GUCA 2a等替代标记与肠道健康、肠道通透性和炎症相关，并可通过RSS进行局部采样。RSS器械的潜在临床用途广泛，可能能够通过更频繁的疾病监测、辅助疾病表征和促进新治疗靶点的识别来指导治疗。
Despite recent developments in therapy for inflammatory bowel diseases (IBDs), there have been limited advances in diagnostic tools available to aid in disease management. A growing body of evidence suggests that there are important host-microbe interactions at the mucosal interface that modulate the inflammatory response in patients with IBD. Additionally, the importance of mucosal integrity and its disruption appears to be important in the pathophysiology and perpetuation of the disease. The ability to characterize this interface may provide valuable information for both disease monitoring and identification of new treatment targets. Endoscopy remains the primary tool for disease monitoring, and mucosal healing is the primary therapeutic target in IBD treatment. However, establishing mucosal healing requires repetitive endoscopic procedures, and endoscopy is limited by factors such as invasiveness, cost, and risk of adverse events. Moreover, the use of a bowel preparation for colonoscopies alters the mucus layer and thus perturbs evaluation of the host-microbe interaction. Stool sampling may also be inaccurate because it reflects the end state of metabolites and proteins, failing to take into account the degradation or alteration of substrates of interest by bacterial proteases and other enzymes during passage through the colon.A novel sampling capsule, called the Recoverable Sampling System (RSS), is being developed as a complementary tool to colonoscopy. The RSS is intended to be a platform for noninvasive autonomous sampling, preservation, handling, and storage of analytes of interest found in the gastrointestinal fluids. A proprietary preservative contained within the chambers of the capsule has been developed to stabilize DNA and proteins for ex vivo microbiome and metabolomics analyses.Surrogate markers such as SPP24 and GUCA2a have been identified to correlate with gut health, intestinal permeability, and inflammation and could be locally sampled by the RSS. The potential clinical utility of an RSS device is broad and would likely be able to guide therapy by allowing for more frequent disease monitoring, aiding in disease characterization, and facilitating in the identification of novel therapeutic targets.