Increased immune reactivity predicts aggressive complicating Crohn's disease in children.
Increased immune reactivity predicts aggressive complicating Crohn's disease in children.
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DOI：
10.1016/j.cgh.2008.04.032
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发表时间：
2008-10
期刊：
影响因子：
--
通讯作者：
Wisconsin Pediatric IBD Alliance
中科院分区：
文献类型：
--
作者：
Dubinsky MC;Kugathasan S;Mei L;Picornell Y;Nebel J;Wrobel I;Quiros A;Silber G;Wahbeh G;Katzir L;Vasiliauskas E;Bahar R;Otley A;Mack D;Evans J;Rosh J;Hemker MO;Leleiko N;Crandall W;Langton C;Landers C;Taylor KD;Targan SR;Rotter JI;Markowitz J;Hyams J;Western Regional Pediatric IBD Research Alliance;Pediatric IBD Collaborative Research Group;Wisconsin Pediatric IBD Alliance
识别出从简单表型快速进展为复杂表型的风险最高的克罗恩病儿童的能力对于指导初始治疗非常有价值。目的：确定免疫反应和/或 CARD15 变异是否与复杂的疾病表型相关并预测疾病进展。从 796 例儿科 CD 病例中收集血清，并使用 ELISA 检测抗 Cbir1（鞭毛蛋白）、抗外膜蛋白 C（抗 OmpC）、抗酿酒酵母 (ASCA) 和核周抗中性粒细胞胞浆抗体 (pANCA)。对 3 个 CARD15 变体（SNP 8、12、13）进行基因分型 (TaqmanMGB)。评估了免疫反应（抗体总和 (AS) 和四分位数总和评分 (QSS)、CARD15 和临床表型之间的关联。32% 的患者在中位 32 个月内出现至少一种疾病并发症，18% 接受了手术。随着 AS 和 QSS 的增加，内穿透 (IP)、狭窄 (S) 和手术的频率显着增加（所有 3 个结果的 p 趋势 < 0.0001）。9% 的患者 血清反应阳性组的 IP/S 相对于血清反应阴性组的 2.9% (p=0.01)。血清反应阳性组中 12% 接受了手术，而血清反应阴性组中这一比例为 2% (p=0.0001)。最高的 AS 组 (3) 和 QSS 组 (4) 表现出最快的疾病进展 (p < 0.0001)。观察到 AS 第 3 组的风险比增加 (7.8 [2.2–28.7] p < 0.002 和 QSS 第 4 组 (11.0 [1.5,83.0] p < 0.02)。随着免疫反应数量和强度的增加，儿童复杂 CD 的发生率也会增加。表达免疫反应的儿童的疾病进展明显更快。
The ability to identify children with Crohn’s disease who are at highest risk for rapid progression from uncomplicated to complicated phenotypes would be invaluable in guiding initial therapy. Aim: To determine whether immune responses and/or CARD15 variants are associated with complicated disease phenotypes and predict disease progression. Sera were collected from 796 pediatric CD cases and tested for anti-Cbir1 (flagellin), anti-outer membrane protein C (anti-OmpC), anti-Saccharomyces-cerevisiae (ASCA) and perinuclear anti-neutrophil cytoplasmic antibody (pANCA) using ELISA. Genotyping (TaqmanMGB) was performed for 3 CARD15 variants (SNPs 8, 12, 13). Associations between immune responses (antibody sum (AS) and quartile sum score (QSS), CARD15, and clinical phenotype were evaluated. 32% of patients developed at least one disease complication within a median of 32 months and 18% underwent surgery. The frequency of internal penetrating (IP), stricturing (S) and surgery significantly increased (p trend < 0.0001 for all 3 outcomes) with increasing AS and QSS. 9% of seropositive groups had IP/S vs. 2.9% in the seronegative group (p=0.01). 12% of seropositive groups underwent surgery vs. 2% in the seronegative group (p=0.0001). The highest AS group (3) and QSS group (4) demonstrated the most rapid disease progression (p < 0.0001). Increased hazard ratio was observed for AS group 3 (7.8 [2.2–28.7] p < 0.002 and QSS group 4 (11.0 [1.5,83.0] p < 0.02). The rate of complicated CD increases in children as the number and magnitude of immune reactivity increases. Disease progression is significantly faster in children expressing immune reactivity.
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影响因子：
9.8
作者：
Dubinsky, MC;Lin, YC;Yang, HY
通讯作者：
Yang, HY
影响因子：
29.4
作者：
Hyams, Jeffrey;Crandall, Wallace;Baldassano, Robert
通讯作者：
Baldassano, Robert
影响因子：
29.4
作者：
Landers, CJ;Cohavy, O;Targan, SR
通讯作者：
Targan, SR
影响因子：
29.4
作者：
Vasiliauskas, EA;Plevy, SE;Targan, SR
通讯作者：
Targan, SR
DOI：
10.1016/s1050-3862(98)00019-9
发表时间：
1999-02-01
期刊：
GENETIC ANALYSIS-BIOMOLECULAR ENGINEERING
影响因子：
--
作者：
Livak, KJ
通讯作者：
Livak, KJ