Clinical features and monocyte/macrophage subsets characterization in granulomatous vs non-granulomatous Crohn's disease
Clinical features and monocyte/macrophage subsets characterization in granulomatous vs non-granulomatous Crohn's disease
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肉芽肿性与非肉芽肿性克罗恩病的临床特征和单核细胞/巨噬细胞亚群特征
DOI：
10.1080/00365521.2020.1748222
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发表时间：
2020
影响因子：
1.9
通讯作者：
Zhang Yan
中科院分区：
文献类型：
--
作者：
Zhao Li;Tang Yu;Lei Na;Zhou D;an;Chen Bingrun;Gan Tao;Yang Xiaoli;Zhang Yan
目的：肉芽肿是克罗恩病的组织学特征，主要由巨噬细胞组成。然而，它在CD中的意义还没有得到充分的研究。我们的研究旨在通过比较肉芽肿和非肉芽肿CD的临床表现和单核/巨噬细胞亚型来解决这一问题。材料和方法：比较肉芽肿和非肉芽肿患者的人口学特征、症状、内窥镜表现、组织病理学特征和蒙特利尔分类。流式细胞仪检测单核细胞吞噬功能及亚群。用双抗体夹心EL ISA法检测血浆中肿瘤坏死因子-α、IL-6、IL-1β、IL-10、CCL2 2、转化生长因子-β1的水平，用免疫组织化学方法检测CD6 8、CD16 3、iNOS的表达。与非肉芽肿性CD患者相比，肉芽肿患者年龄更小，腹泻和肛周并发症的发生率更高，内窥镜评分也更高。肠管狭窄和隐窝脓肿多见于肉芽肿性CD患者。肉芽肿性CD患者单核细胞吞噬功能存在缺陷。同时，在它们中发现了较高比例的中间单核细胞和非典型单核细胞，较低比例的典型单核细胞。结论：肉芽肿型CD患者与非肉芽肿型CD患者相比，具有不同的临床表现。结论：肉芽肿型CD患者的β-α水平明显低于非肉芽肿型CD患者。肉芽肿CD患者可能需要更积极的治疗。此外，单核/巨噬细胞亚群的异质性和血浆细胞因子的改变可能是这两组之间差异的基础。
Aims:Granuloma, mainly composed of macrophages, is a histological feature of Crohn’s disease (CD). However, its significance in CD has not been investigated adequately. Our study aims to address this issue by comparing the clinical manifestations and monocyte/macrophage subtypes between granulomatous and non-granulomatous CD.Materials and methods:Demographics, symptoms, endoscopic manifestations, histopathological features, and Montreal classification of patients with and without granulomas were compared. Flow cytometry was used to determine the phagocytosis and subsets of monocytes. ELISA was used to measure the plasma levels of TNF-α, IL-6, IL-1β, IL-10, CCL22, and TGF-β1. Immunohistochemistry was performed to quantify the expression of CD68, CD163 and iNOS.Results:Of the222 CD patients enrolled, granulomas were detected in 90. Compared with non-granulomatous CD patients, those with granulomas had younger age, increased rates of diarrhea and perianal complications, along with higher endoscopic score. Intestinal stenosis and crypt abscess were more frequently observed in granulomatous CD patients. A defective phagocytosis of monocytes was observed in granulomatous CD patients. Meanwhile, higher percentages of intermediate and non-classic monocytes, with a lower percentage of classic monocyte were found in them. Besides, they had higher levels of TGF-β1 and IL-10, a lower level of TNF-α, an increased ratio of CD163+/CD68+cells, and a decreased ratio of iNOS+/CD68+cells.Conclusions:Granulomatous CD patients exhibited different manifestations compared with their non-granulomatous counterparts. More aggressive therapy may be needed in granulomatous CD patients. Furthermore, the heterogeneity of monocyte/macrophage subsets and altered plasma cytokine may underlie the difference between those two groups.