Immunological examination and efficacy of immunomodulator in pediatric inflammatory bowel disease

近年来，炎症性肠病发病年龄的降低较为超前，认为饮食习惯的改变和卫生环境的改善起了很大的作用。本研究的目的是探讨儿童炎症性肠病在发展过程中的免疫变化和免疫调节剂的疗效。与缓解期相比，在儿童UC和CD患者的急性期检测到血清Il-4和Il-6水平显著升高。与正常黏膜相比，GATA-3和STAT-4在儿童UC急性期的黏膜表达明显增强。这些结果提示IL-4及其信号分子GATA-3和Th1信号分子STAT-4参与了儿童UC急性期的发病。日本儿童维持缓解所需的6-MP剂量低于西方国家报道的剂量。然而，该人群中的6-TGN浓度高于先前报道的水平。这被认为是受种族代谢差异和其他药物使用的影响。

In recent years, the lowering of the age of the inflammatory bowel disease is advanced and it is thought that the change in eating habits and the hygienic environment takes part greatly. The objective of this study was to examine the change in immunity and the efficacy of immunomodulatory agents in pediatric inflammatory bowel disease in developing process. Significant elevation of serum Il-4 and Il-6 levels was detected at the acute phase of pediatric UC and CD patients compared with levels at the remission. The mucosal expression of GATA-3 and STAT-4 were significantly enhanced in the acute phase of pediatric UC patients compared with normal mucosa. These results suggest that IL-4 and its signaling molecule GATA-3, as well as the Th1 signaling molecule STAT-4, are involved in the pathogenesis of acute phase of pediatric UC. The doses of 6-MP need to maintain remission in Japanese children are lower than those reported in Western countries. However, 6-TGN concentrations in this population are higher than those previously reported. It is thought to be affected by the differences in racial metabolizing and the usage of other medicines.