Assessment of serum cytokines predicts clinical and endoscopic outcomes to vedolizumab in ulcerative colitis patients
Assessment of serum cytokines predicts clinical and endoscopic outcomes to vedolizumab in ulcerative colitis patients
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DOI：
10.1111/bcp.14235
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发表时间：
2020-02-18
影响因子：
3.4
通讯作者：
Costa, Francesco
中科院分区：
文献类型：
--
作者：
Bertani, Lorenzo;Baglietto, Laura;Costa, Francesco
目的：Vedolizumab（VDZ）可防止活化白细胞迁移至炎症粘膜。本研究旨在评估基线和VDZ治疗期间溃疡性结肠炎（UC）患者血清细胞因子的模式，并研究其与粘膜愈合和临床缓解的相关性。在第0、6和22周通过荧光测定法测量一组血清细胞因子。在基线和第54周进行结肠镜检查，以评价粘膜愈合。时间趋势的血清细胞因子进行了分析，对数线性混合效应模型，其预后的准确性进行了评估logistic regression.Results出27例纳入分析，在第54周粘膜愈合12（44%）和临床缓解17（63%）。粘液瘤愈合与基线时较高的白细胞介素（IL）-8值以及前6周内IL-6和IL-8水平的显著降低相关。治疗前6周内IL-6和IL-8水平的显著降低也与临床缓解相关。Logistic模型包括基线时IL-6和IL-8及其在治疗前6周内的变化，预测粘膜愈合的敏感性为83%，特异性为87%，预测临床缓解的敏感性为82%，特异性为90%。基线时和VDZ治疗前6周内IL-6和IL-8的血清模式可用于预测治疗结局。
Aims Vedolizumab (VDZ) prevents migration of activated leucocytes into inflamed mucosa. This study aimed to assess the patterns of serum cytokines in ulcerative colitis (UC) patients at baseline and during VDZ treatment, and to investigate their association with mucosal healing and clinical remission.Methods We enrolled consecutive UC patients eligible for treatment with VDZ. A panel of serum cytokines were measured by fluorescence assay at weeks 0, 6 and 22. Colonoscopy was performed at baseline and week 54, to evaluate mucosal healing. The time trends of serum cytokines were analysed by log-linear mixed effect models, and their prognostic accuracy was evaluated by logistic regression.Results Out of 27 patients included in the analysis, at week 54 mucosal healing was achieved in 12 (44%) and clinical remission in 17 (63%). Mucosal healing was associated with higher interleukin (IL)-8 values at baseline and with significant decrease in IL-6 and IL-8 levels over the first 6 weeks. A significant reduction of IL-6 and IL-8 levels over the first 6 weeks of treatment was associated also with clinical remission. Logistic models including, among the predictors, IL-6 and IL-8 at baseline and their changes over the first 6 weeks of treatment had 83% sensitivity and 87% specificity to predict mucosal healing, and 82% sensitivity and 90% specificity to predict clinical remission.Conclusion In UC patients, the serum patterns of IL-6 and IL-8 at baseline and over the first 6 weeks of treatment with VDZ could be useful to predict therapeutic outcome.