Fecal Amino Acid Analysis Can Discriminate De Novo Treatment-Naive Pediatric Inflammatory Bowel Disease From Controls
Fecal Amino Acid Analysis Can Discriminate De Novo Treatment-Naive Pediatric Inflammatory Bowel Disease From Controls
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DOI：
10.1097/mpg.0000000000001812
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发表时间：
2018-05-01
影响因子：
2.9
通讯作者：
de Meij, Tim G. J.
中科院分区：
文献类型：
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作者：
Bosch, Sofie;Struys, Eduard A.;de Meij, Tim G. J.
目的：内窥镜检查在炎症性肠病（IBD）的诊断检查中仍然是强制性的，但它是一种昂贵的侵入性检查。识别新颖的、非侵入性的诊断生物标志物仍然是一个优先事项。本研究的目的是探讨粪便氨基酸成分作为儿科 IBD 诊断生物标志物的潜力。方法：在这项病例对照研究中，纳入了来自两个三级中心的初治 IBD 儿科患者。溃疡性结肠炎 (UC) 和克罗恩病 (CD) 的内镜严重程度基于医生整体评估评分，并通过研究纳入时粪便钙卫蛋白和 C 反应蛋白水平证实。指示患者在肠道清洁之前收集粪便样本。从同一地区的小学招募健康对照（HC）。对所有样本进行专门的氨基酸分析。结果：30 名 IBD 患者（15 UC、15 CD）与 15 名年龄和性别匹配的 HC 之间发现 6 种氨基酸（组氨酸、色氨酸、苯丙氨酸、亮氨酸、酪氨酸和缬氨酸；所有曲线下面积 >0.75 且 P < 0.005）存在显着差异，在 IBD 中表现出较高水平。根据 IBD 类型对患者进行分配时，UC 和 HC 之间相似的氨基酸谱（组氨酸、色氨酸、苯丙氨酸、亮氨酸、缬氨酸和丝氨酸）存在差异，而 CD 和 HC 之间有 3 个氨基酸不同（组氨酸、色氨酸和苯丙氨酸）。结论：在 IBD 患者中发现六种不同粪便氨基酸的水平显着升高。 IBD 与对照相比。需要阐明这些差异是否反映了肠道发炎导致的吸收减少或损失增加。
Objectives: Endoscopy remains mandatory in the diagnostic work-up of inflammatory bowel disease (IBD), but is a costly and invasive procedure. Identification of novel, noninvasive, diagnostic biomarkers remains a priority. The aim of the present study was to explore the potential of fecal amino acid composition as diagnostic biomarker for pediatric IBD.Methods: In this case-control study, treatment-naive, de novo pediatric patients with IBD from two tertiary centers were included. Endoscopic severity of ulcerative colitis (UC) and Crohn's disease (CD) was based on physician global assessment scores, substantiated by levels of fecal calprotectin and C-reactive protein at study inclusion. Patients were instructed to collect a fecal sample prior to bowel cleansing. Healthy controls (HCs) were recruited from primary schools in the same region. Dedicated amino acid analysis was performed on all samples.Results: Significant differences between 30 IBD patients (15 UC, 15 CD) and 15 age and sex-matched HCs were found in six amino acids (histidine, tryptophan, phenylalanine, leucine, tyrosine, and valine; all area under the curve >0.75 and P < 0.005), displaying higher levels in IBD. When distributing the patients according to type of IBD, a similar spectrum of amino acids differed between UC and HC (histidine, tryptophan, phenylalanine, leucine, valine, and serine), whereas three amino acids were different between CD and HC (histidine, tryptophan, and phenylalanine).Conclusions: Significantly increased levels of six different fecal amino acids were found in patients with IBD compared to controls. Whether these differences reflect decreased absorption or increased loss by inflamed intestines needs to be elucidated.