利用分馏呼出一氧化氮、血液和粪便生物标记物对嗜酸性粒细胞食管炎进行无创疾病评估

IF 2.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Andreas Göldi, Tanay Kaymak, Luca Esposito, Anouk Lehmann, Simona Negoias, Michael Tamm, Jan Hendrik Niess, Petr Hruz
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引用次数: 0

摘要

背景:嗜酸性粒细胞食管炎(EoE)是一种由食物和航空过敏原引发的慢性食管炎症。目前需要一种非侵入性生物标志物来可靠地检测有主要症状的嗜酸性粒细胞食管炎患者,并预测治疗反应,以减少内镜评估:研究:2020 年 11 月至 2022 年 5 月期间,对 18 岁或以上疑似或确诊为胃食管反流病(GERD)的非哮喘患者以及有内镜检查指征的对照组患者进行前瞻性招募。受试者接受体褶式压力计和分馏呼出一氧化氮(FeNO)水平测量。此外,还通过酶联免疫吸附法测定了血清和粪便生物标志物。活动性咽喉炎患者在开始治疗后接受了随访检查:结果:与胃食管反流病(15 ppb,P=0.038)和对照组(14 ppb,P=0.046)相比,活动性咽喉炎患者的中位 FeNO 水平(20 ppb)较高。在治疗反应后接受随访评估的咽喉炎患者中,中位 FeNO 没有明显差异(20 ppb 对 18 ppb,P=0.771)。与对照组相比,活动性胃食管反流患者的血清 EDN、ECP 和嗜酸性粒细胞绝对血细胞计数(AEC)升高,但与胃食管反流病相比,除 AEC 外,其他指标均未升高。在随访评估中,缓解期肠炎患者的血清 EDN、ECP 和 AEC 均有所下降。在活动性呃逆或治疗期间,粪便生物标志物均未升高:结论:对 FeNO 的评估可能具有诊断价值,可用于区分活动性咽喉炎患者和非咽喉炎患者,但不是监测疾病活动的合适标志物。血清中的 EDN、ECP、TARC 和 AEC 水平正逐渐成为监测咽喉炎疾病活动的潜在候选指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Noninvasive Disease Assessment in Eosinophilic Esophagitis With Fractionated Exhaled Nitric Oxide, Blood, and Fecal Biomarkers.

Background: Eosinophilic Esophagitis (EoE) is a chronic inflammatory condition of the esophagus triggered by food and aeroallergens. There is a need for noninvasive biomarkers that reliably detect EoE in patients with cardinal symptoms and predict treatment response to reduce endoscopic evaluations.

Study: Nonasthmatic patients 18 years or above with suspected or diagnosed EoE, gastroesophageal reflux disease (GERD), and control individuals with indication for endoscopy were enrolled prospectively between November 2020 and May 2022. Participants underwent body plethysmography with fractionated exhaled nitric oxide (FeNO) level measurement. Besides, serum and fecal biomarkers were measured by ELISA. A follow-up examination was scheduled after treatment initiation in patients with active EoE.

Results: The median FeNO level in active EoE (20 ppb) was higher compared with GERD (15 ppb, P=0.038) and control individuals (14 ppb, P=0.046). Median FeNO did not significantly differ in EoE patients who underwent follow-up assessment after treatment response (20 ppb vs. 18 ppb, P=0.771). Serum EDN, ECP, and the absolute eosinophil blood count (AEC) were elevated in active EoE compared with control individuals but not compared with GERD except for AEC. Serum EDN, ECP and AEC decreased in EoE in remission at follow-up assessment. None of the fecal biomarkers was elevated in active EoE or during treatment.

Conclusions: Assessment of FeNO may have diagnostic value in differentiating patients with active EoE from non-EoE patients but is not a suitable marker for monitoring disease activity. Serum EDN, ECP, TARC, and AEC levels are emerging as potential candidates for monitoring disease activity in EoE.

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来源期刊
Journal of clinical gastroenterology
Journal of clinical gastroenterology 医学-胃肠肝病学
CiteScore
5.60
自引率
3.40%
发文量
339
审稿时长
3-8 weeks
期刊介绍: Journal of Clinical Gastroenterology gathers the world''s latest, most relevant clinical studies and reviews, case reports, and technical expertise in a single source. Regular features include cutting-edge, peer-reviewed articles and clinical reviews that put the latest research and development into the context of your practice. Also included are biographies, focused organ reviews, practice management, and therapeutic recommendations.
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