Cytokine imbalance in irritable bowel syndrome: a systematic review and meta-analysis
Cytokine imbalance in irritable bowel syndrome: a systematic review and meta-analysis
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DOI：
10.1111/nmo.12358
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发表时间：
2014-07-01
影响因子：
3.5
通讯作者：
Simren, M.
中科院分区：
文献类型：
--
作者：
Bashashati, M.;Rezaei, N.;Simren, M.
背景：肠易激综合征(IBS)是一种病因不明的功能性胃肠道疾病，尽管近年来感染和炎症被认为是重要的病因。最近的一项荟萃分析显示，细胞因子[白介素10(IL-10)和肿瘤坏死因子(TNF)]基因多态性与IBS存在相关性；然而，目前尚不清楚IBS患者是否具有与健康人群不同的细胞因子谱。方法根据PubMed和EMBASE Search 2013年8月的病例对照研究资料，进行系统回顾和荟萃分析，以确定血清/血浆或黏膜中IL-10/肿瘤坏死因子-α水平与IBS的关系。用逆方差法产生标准化均值差(SMD)。根据I2值评估异质性。结果IBS患者血清/血浆中肿瘤坏死因子-α水平明显高于对照组(P=0.09)，且在IBS各亚型与对照组及女性IBS患者间差异均有统计学意义。然而，IBS患者的血清/血浆IL-10水平与对照组相比无显著差异。对IBS各亚型血清/血浆IL-10水平的进一步分析没有显示出任何差异；然而，基于性别的分析显示，男性IBS患者的血清/血浆IL-10水平显著低于男性对照组(p=0.02)。IBS患者结肠IL-10mRNA的表达明显低于对照组(p=0.001)。结论：提示IBS患者存在促炎性细胞因子和抗炎性细胞因子的失衡。根据细胞因子谱对IBS患者进行分层可能代表着个体化治疗这种情况的机会。
Background Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of unknown etiology; although infection and inflammation have recently been considered as important etiologic agents. A recent meta-analysis showed correlations between cytokine [interleukin-10 (IL-10) and tumor necrosis factor (TNF)] gene polymorphisms and IBS; however, it is still unknown whether patients with IBS have different cytokine profiles compared to healthy population. Methods To determine the relationships between serum/plasma levels or mucosal expression of IL-10/TNF- and IBS, we conducted a systematic review and meta-analysis based on case-control studies retrieved from PubMed and EMBASE search through August 2013. Standardized mean difference (SMD) was generated by using the inverse variance method. Heterogeneity was assessed based on I2 values. Key Results Serum/plasma levels of TNF- tended to be higher in IBS vs controls (p=0.09); this reached significance in IBS subtypes vs controls and in female patients with IBS. However, serum/plasma levels of IL-10 were not significantly different in IBS patients vs controls. Further analysis of serum/plasma IL-10 levels in IBS subtypes did not show any difference; however, analysis based on gender showed a significantly lower serum/plasma IL-10 levels in male patients with IBS vs male controls (p=0.02). Colonic IL-10 mRNA had a significantly lower expression in IBS vs control (p=0.001). Conclusions & Inferences There is an imbalance of proinflammatory TNF-, and anti-inflammatory IL-10, cytokines in IBS. Stratifying IBS patients based on cytokine profile may represent an opportunity for personalized treatment of this condition.