{"title":"评估氨基酸瓜氨酸作为乳糜泻诊断替代代谢组生物标记物的效用","authors":"Avinash Lomash, Anupa Prasad, Raghvendra Singh, Somesh Kumar, Rishi Gupta, Dhwani Dholakia, Praveen Kumar, Vineeta V Batra, Amarender S Puri, Seema Kapoor","doi":"10.1177/11786388211060603","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Citrulline is regarded as a biomarker for celiac disease (CD). Its utility for assessment and evaluation of additive predictive value for latent, potential CD and first degree relatives (FDRs) needs exploration.</p><p><strong>Method: </strong>Consecutive 558 index cases diagnosed as per European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN) 2012 guidelines and their 1565 FDRs were evaluated over five and half year period. Serology negative FDRs at initial visit and follow ups were served as controls. HLA typing for DQ2 and DQ8 genotypes, along with plasma and dried blood spot (DBS) filter paper citrulline were evaluated.</p><p><strong>Results: </strong>Median plasma citrulline values were 20.1 and 37.33 µMol/l in cases and controls (<i>P</i> < .001). Cut off values for Marsh grade 3a, 3b, and 3c were 35.0, 32.8, 25.26 µMol/l in CD patients and 36.51, 30.10, 25.26 µMol/l in biopsy proven FDR. Increasing trends of plasma citrulline levels with decreasing tTG-IgA levels were observed on follow up. Low plasma citrulline levels were observed with HLA DQ 2.5 genotype (<i>P</i> < .05). Agreement between DBS and plasma citrulline was 94.8%.</p><p><strong>Conclusion: </strong>Citrulline is a good surrogate biomarker for identification of histopathological grade of damage, extent of mucosal recovery and has negative correlation with tTG-IgA. It identifies the silent and latent phase of CD. DBS citrulline provides adequate information and can be used for monitoring CD patients at remote locations.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":"14 ","pages":"11786388211060603"},"PeriodicalIF":2.3000,"publicationDate":"2021-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/1a/10.1177_11786388211060603.PMC8655831.pdf","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the Utility of Amino Acid Citrulline as a Surrogate Metabolomic Biomarker for the Diagnosis of Celiac Disease.\",\"authors\":\"Avinash Lomash, Anupa Prasad, Raghvendra Singh, Somesh Kumar, Rishi Gupta, Dhwani Dholakia, Praveen Kumar, Vineeta V Batra, Amarender S Puri, Seema Kapoor\",\"doi\":\"10.1177/11786388211060603\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Citrulline is regarded as a biomarker for celiac disease (CD). Its utility for assessment and evaluation of additive predictive value for latent, potential CD and first degree relatives (FDRs) needs exploration.</p><p><strong>Method: </strong>Consecutive 558 index cases diagnosed as per European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN) 2012 guidelines and their 1565 FDRs were evaluated over five and half year period. Serology negative FDRs at initial visit and follow ups were served as controls. HLA typing for DQ2 and DQ8 genotypes, along with plasma and dried blood spot (DBS) filter paper citrulline were evaluated.</p><p><strong>Results: </strong>Median plasma citrulline values were 20.1 and 37.33 µMol/l in cases and controls (<i>P</i> < .001). Cut off values for Marsh grade 3a, 3b, and 3c were 35.0, 32.8, 25.26 µMol/l in CD patients and 36.51, 30.10, 25.26 µMol/l in biopsy proven FDR. Increasing trends of plasma citrulline levels with decreasing tTG-IgA levels were observed on follow up. Low plasma citrulline levels were observed with HLA DQ 2.5 genotype (<i>P</i> < .05). Agreement between DBS and plasma citrulline was 94.8%.</p><p><strong>Conclusion: </strong>Citrulline is a good surrogate biomarker for identification of histopathological grade of damage, extent of mucosal recovery and has negative correlation with tTG-IgA. It identifies the silent and latent phase of CD. DBS citrulline provides adequate information and can be used for monitoring CD patients at remote locations.</p>\",\"PeriodicalId\":19396,\"journal\":{\"name\":\"Nutrition and Metabolic Insights\",\"volume\":\"14 \",\"pages\":\"11786388211060603\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2021-12-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/1a/10.1177_11786388211060603.PMC8655831.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nutrition and Metabolic Insights\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/11786388211060603\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition and Metabolic Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11786388211060603","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
引言瓜氨酸被认为是乳糜泻（CD）的生物标志物。它在评估和评价潜伏、潜在 CD 和一级亲属 (FDR) 的附加预测值方面的效用有待探索：方法：对根据欧洲儿科胃肠病学和营养学会（ESPGHAN）2012年指南确诊的558例指数病例及其1565名一级亲属进行了为期五年半的评估。初诊和随访时血清学阴性的 FDR 作为对照。对DQ2和DQ8基因型的HLA分型以及血浆和干血斑（DBS）滤纸瓜氨酸进行了评估：结果：病例和对照组的血浆瓜氨酸中位值分别为 20.1 和 37.33 µMol/l（P P 结论：瓜氨酸是一种良好的降血脂药物：瓜氨酸是一种很好的替代生物标志物，可用于鉴别组织病理学损伤等级和粘膜恢复程度，并与 tTG-IgA 呈负相关。它能识别 CD 的沉默期和潜伏期。DBS 瓜氨酸能提供足够的信息，可用于监测远距离的 CD 患者。
Evaluation of the Utility of Amino Acid Citrulline as a Surrogate Metabolomic Biomarker for the Diagnosis of Celiac Disease.
Introduction: Citrulline is regarded as a biomarker for celiac disease (CD). Its utility for assessment and evaluation of additive predictive value for latent, potential CD and first degree relatives (FDRs) needs exploration.
Method: Consecutive 558 index cases diagnosed as per European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN) 2012 guidelines and their 1565 FDRs were evaluated over five and half year period. Serology negative FDRs at initial visit and follow ups were served as controls. HLA typing for DQ2 and DQ8 genotypes, along with plasma and dried blood spot (DBS) filter paper citrulline were evaluated.
Results: Median plasma citrulline values were 20.1 and 37.33 µMol/l in cases and controls (P < .001). Cut off values for Marsh grade 3a, 3b, and 3c were 35.0, 32.8, 25.26 µMol/l in CD patients and 36.51, 30.10, 25.26 µMol/l in biopsy proven FDR. Increasing trends of plasma citrulline levels with decreasing tTG-IgA levels were observed on follow up. Low plasma citrulline levels were observed with HLA DQ 2.5 genotype (P < .05). Agreement between DBS and plasma citrulline was 94.8%.
Conclusion: Citrulline is a good surrogate biomarker for identification of histopathological grade of damage, extent of mucosal recovery and has negative correlation with tTG-IgA. It identifies the silent and latent phase of CD. DBS citrulline provides adequate information and can be used for monitoring CD patients at remote locations.
期刊介绍：
Nutrition and Metabolic Insights is a peer-reviewed, open-access online journal focusing on all aspects of nutrition and metabolism. This encompasses nutrition, including the biochemistry of metabolism, exercise and associated physical processes and also includes clinical articles that relate to metabolism, such as obesity, lipidemias and diabetes. It includes research at the molecular, cellular and organismal levels. This journal welcomes new manuscripts for peer review on the following topics: Nutrition, including the biochemistry of metabolism, Exercise and associated physical processes, Clinical articles that relate to metabolism, such as obesity, lipidemias and diabetes, Research at the molecular, cellular and organismal levels, Other areas of interest include gene-nutrient interactions, the effects of hormones, models of metabolic function, macronutrient interactions, outcomes of changes in diet, and pathophysiology.
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