Looking into Enteric Virome in Patients with IBD: Defining Guilty or Innocence?
Looking into Enteric Virome in Patients with IBD: Defining Guilty or Innocence?
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DOI：
10.1097/mib.0000000000001167
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发表时间：
2017-08-01
影响因子：
4.9
通讯作者：
Macedo, Guilherme
中科院分区：
文献类型：
--
作者：
Lopes, Susana;Andrade, Patricia;Macedo, Guilherme
背景：虽然有一些证据表明某些病毒可能参与炎症性肠病（IBD）的发病，但关于IBD患者血液和粘膜中病毒流行率和病毒载量的数据很少。本研究的主要目的是评估成人内镜下活动性IBD患者血液和粘膜中常见eb病毒（EBV）、巨细胞病毒（CMV）和人类疱疹病毒6的感染率和病毒载量。方法：2014年1 - 12月，连续入选溃疡性结肠炎和克罗恩病合并活动性内镜疾病患者。接受结直肠癌结肠镜检查的受试者作为健康对照（hc）。收集每位患者和HC的配对血液和粘膜样本，用于EBV、CMV和人类疱疹病毒6的定量实时聚合酶链反应病毒载量评估。结果：纳入145名受试者；95例伴有活动性内窥镜疾病的IBD患者（溃疡性结肠炎43例，克罗恩病52例）和50名健康受试者。无论IBD类型如何，CMV和EBV DNA在IBD患者粘膜中的检测频率高于hc （CMV P = 0.017; EBV P < 0.001）。在IBD和hc患者的血液和粘膜中检测人类疱疹病毒6 DNA的频率没有差异。EBV中位病毒载量在炎症和非炎症粘膜中相似，不受使用免疫调节剂和/或抗肿瘤坏死因子α药物的影响，并且与内镜下疾病活动性无关。结论：EBV和较小程度的CMV在IBD患者中比在hc患者中更普遍。粘膜病毒载量不受治疗方案的影响，炎症和非炎症粘膜之间没有差异，并且似乎不受疾病的内镜活动的影响，这表明EBV可能更多地参与IBD的发病，而不是其严重程度和临床演变。
Background: Although there is some evidence suggesting that certain viruses may be involved in the onset of inflammatory bowel disease (IBD), data regarding viral prevalence and viral load in blood and mucosa of patients with IBD are scarce. The main aim of this study is to evaluate the prevalence and viral load of common Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus 6 in blood and mucosa of adult patients with endoscopic active IBD.Methods: From January to December 2014, ulcerative colitis and Crohn's disease patients with active endoscopic disease were consecutively enrolled. Subjects undergoing colonoscopy for colorectal cancer screening served as healthy controls (HCs). Paired blood and mucosal samples from each patient and HC were collected for EBV, CMV, and human herpes virus 6 quantitative real time polymerase chain reaction assessment of the viral load.Results: One hundred forty-five subjects were included; 95 IBD patients with active endoscopic disease (43 ulcerative colitis and 52 Crohn's disease) and 50 healthy subjects. CMV and EBV DNA were detected more frequently in the mucosa of patients with IBD compared with HCs (CMV P = 0.017; EBV P < 0.001), irrespective of IBD type. The frequency of human herpes virus 6 DNA detection both in the blood and in the mucosa did not differ between patients with IBD and HCs. EBV median viral load was similar in the inflamed and noninflamed mucosa was not affected by the use of immunomodulators and/or anti-tumor necrosis factor alpha agents, and did not correlate with endoscopic disease activity.Conclusions: EBV, and to a lesser extent CMV, were more prevalent in patients with IBD than in HCs. Mucosal viral load was not influenced by the therapeutic regimen, did not differ between inflamed and noninflamed mucosa, and did not seem to be influenced by the endoscopic activity of the disease, suggesting that EBV may be more involved in the onset of IBD than in its severity and clinical evolution.