Fecal excretion of deoxyribonucleic acid in long-term follow-up of patients with inactive ulcerative colitis
Fecal excretion of deoxyribonucleic acid in long-term follow-up of patients with inactive ulcerative colitis
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DOI：
10.1002/ibd.20042
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发表时间：
2007-04-01
影响因子：
4.9
通讯作者：
Malagelada, Juan-R.
中科院分区：
文献类型：
--
作者：
Casellas, Francesc;Borruel, Natalia;Malagelada, Juan-R.
背景：我们假设受损结肠粘膜中上皮细胞和炎症细胞的管腔脱落增加，从而开发出一种测量人类 DNA 粪便排泄量的技术。然而，该技术在溃疡性结肠炎患者随访中的临床有效性尚未确定。本研究的目的是确定非活动性溃疡性结肠炎粪便 DNA 的稳定性及其作为复发指标的潜在价值。 方法：本前瞻性研究中的 54 名临床静止期溃疡性结肠炎患者随访 12 个月或直至临床复发（临床活动指数 > 7）。采用ELISA法测定粪便钙卫蛋白浓度，采用定量PCR法测定粪便DNA浓度。结果：随访一年内，54例患者中有23例复发，结肠炎活动指数中位数从1.0增加至8.0（P < 0.01）。稳定、非活动性结肠炎患者的粪便 DNA 中位数保持不变，范围从纳入时的 6.8 拷贝/μg 到随访结束时的 1.7 拷贝/μg。粪便钙卫蛋白水平也没有变化，范围从纳入时的 414.0 μg/g 到随访结束时的 128.9 μg/g。相比之下，复发患者的粪便 DNA 浓度显着增加（入组时为 259.0 拷贝/μg，P < 0.01）。粪便钙卫蛋白也观察到复发患者的类似增加。用于评估粪便 DNA 和钙卫蛋白在随访期间检测复发的准确性的 ROC 曲线分析得出了类似的结果。结论：非活动性溃疡性结肠炎患者粪便 DNA 浓度保持稳定，但随着复发而显着增加。测定粪便 DNA 浓度可能是一种用于患者随访的新客观工具。
Background: We have developed a technique for measuring fecal excretion of human DNA by assuming that luminal desquamtion of epithelial and inflammatory cells increases in damaged colonic mucosa. However, the clinical usefulness of this technique in the follow-up of patients with ulcerative colitis has not been established. The aim of this study was to determine the stability of fecal DNA in inactive ulcerative colitis and its potential value as an indicator of relapse.Methods: The 54 patients with clinically quiescent ulcerative colitis in this prospective study were followed for 12 months or until clinical relapse (clinical activity index > 7). Fecal calprotectin concentration was determined by ELISA, and fecal DNA concentration was determined by quantitative PCR.Results: During the year of follow-up, 23 of the 54 patients relapsed, with a median increase in the colitis activity index from 1.0 to 8.0 (P < 0.01). Median fecal DNA remained unchanged in patients with stable, inactive colitis, ranging from 6.8 copies/mu g at inclusion to 1.7 copies/mu g at the end of follow-up. Fecal calprotectin level also was unchanged, ranging from 414.0 mu g/g at inclusion to 128.9 mu g/ at the end of follow-up. In contrast, fecal DNA concentration increased significantly in patients who relapsed (259.0 versus 3.9 copies/mu g at entry; P < 0.01). Similar increases in relapsing patients were also observed with fecal calprotectin. ROC curve analysis to assess the accuracy of fecal DNA and calprotectin in detecting relapses during follow-up yielded similar results.Conclusions: Fecal DNA concentration remained stable in patients with inactive ulcerative colitis but increased significantly with relapses. Determining fecal DNA concentration may be a new objective instrument to use in the follow-up of patients.