[Relevance of serologic studies in inflammatory bowel diseases].
[Relevance of serologic studies in inflammatory bowel diseases].
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DOI：
10.1556/oh.2007.28064
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发表时间：
2007-05-13
期刊：
影响因子：
0.6
通讯作者：
Lakatos, Peter Laszlo
中科院分区：
文献类型：
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作者：
Papp, Maria;Altorjay, Istvan;Lakatos, Peter Laszlo
炎症性肠病(IBD)的血清学标志物小组正在迅速扩大。尽管抗酿酒酵母抗体(ASCA)和非典型核周抗中性粒细胞胞浆抗体(非典型P-ANCA)仍然是研究最广泛的，但针对各种微生物抗原的新发现的抗体的实验数据越来越多。这些抗体包括抗OMPC(外膜孔蛋白C)、抗荧光假单胞菌(抗I2)和抗糖链抗体(抗层粘连糖苷抗体[ALCA])、抗壳聚糖抗体(ACCA)、抗甘露糖苷碳水化合物抗体(AMCA)和抗CBir1；后者是第一个在IBD动物模型中诱导结肠炎的细菌抗原，也能在IBD患者中引起病理免疫反应(抗鞭毛蛋白抗体)。由于各种抗体的敏感性有限，在目前的IBD诊断算法中评估各种抗体的作用是相当值得怀疑的。相比之下，血清学标志物与疾病行为和表型的关联正越来越成为人们感兴趣的焦点。越来越多的观察证实，克罗恩病患者与那些没有或抗体滴度低的患者相比，更有可能患有复杂的小肠疾病(例如狭窄和/或穿孔)，并面临更高的手术风险。根据血清学反应创建同质疾病亚组可能有助于开发更标准化的治疗方法，并可能有助于更好地了解IBD的发病机制。需要进一步的前瞻性临床研究来确定血清学检测在IBD中的临床作用。
The panel of serologic markers for inflammatory bowel diseases (IBDs) is rapidly expanding. Although anti- Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophil cytoplasmic antibodies (atypical P-ANCA) remain the most widely investigated, an increasing amount of experimental data is available on newly discovered antibodies directed against various microbial antigens. Such antibodies include anti-OmpC (outer membrane porin C), anti- Pseudomonas fluorescens (anti-I2) and antiglycan antibodies (anti-laminaribioside carbohydrate antibody [ALCA]), anti-chitobioside carbohydrate antibody [ACCA]), anti-mannobioside carbohydrate antibody [AMCA]) and anti-CBir1; this latter is the first bacterial antigen to induce colitis in animal models of IBD and also leads to a pathological immune response in IBD patients (anti-flagellin antibody). The role of assessment of various antibodies in the current diagnostic algorithm of IBD is rather questionable due to their limited sensitivity. In contrast, the association of serologic markers with disease behavior and phenotype is getting more into the focus of interest. An increasing number of observations confirm that patients with Crohn's disease expressing multiple serologic markers at high titers are more likely to have complicated small bowel disease (e.g. stricture and/or perforation) and are at higher risk for surgery than those without, or with low titer of antibodies. Creating homogenous disease sub-groups based on serologic response may help develop more standardized therapeutic approaches and may help in a better understanding of the pathomechanism of IBD. Further prospective clinical studies are needed to establish the clinical role of serologic tests in IBD.