在IBD中的生物标志物:如何用于诊断?
Renata D'Incà1, Giulia Sturniolo2
1Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35124 Padua, Italy.
Diagnostics (Basel, Switzerland)
|September 28, 2023
概括
炎症性肠病 (IBD) 诊断的生物标志物正在发展. 虽然目前的标记物,如C-反应蛋白和红细胞沉积率有局限性,但新的蛋白质组方法对早期IBD检测有希望.
科学领域:
- 胃肠病学 胃肠病学
- 临床诊断 临床诊断 临床诊断
- 生物标志物研究 生物标志物研究
背景情况:
- 目前用于炎症性肠病 (IBD) 的生物标志物的诊断实用性仍然不完全定义.
- 已建立的标记物,如C-反应蛋白 (CRP) 和红细胞沉率 (ESR),具有固有的局限性,影响其在IBD诊断中的准确性和适用性.
- 便标记物和新兴的免疫学标记物显示出潜力,但需要进一步验证以进行临床整合.
研究的目的:
- 批判性地评估用于诊断炎症性肠病的现有生物标志物.
- 探索新型诊断方法的潜力,包括蛋白质组方法,以改善IBD检测和风险分层.
主要方法:
- 审查和分析常用的IBD生物标志物的性能特征,包括C反应蛋白 (CRP) 和红细胞沉积率 (ESR).
- 评估便标记物和微生物抗体的诊断准确性和限制.
- 探索蛋白质组技术的潜力,以识别IBD的新便生物标志物.
主要成果:
- 在克罗恩氏病中,C-反应蛋白 (CRP) 的表现比性结肠炎更好,在炎症后迅速升高.
- 红细胞沉积率 (ESR) 是可访问和廉价的,但由于其长半衰期和易受年龄和贫血等混因素的影响而受到限制.
- 便标记物具有良好的特异性,但缺乏最佳准确性;新型免疫学标记物和蛋白质组方法有希望,但需要进一步的临床证据.
结论:
- 目前用于炎症性肠病 (IBD) 的生物标志物存在重大限制,影响其诊断可靠性.
- 便的蛋白质组分析为开发用于早期IBD风险识别的敏感和特定生物标志物面板提供了有希望的未来方向.
- 进一步的研究是必要的,以验证新的生物标志物在临床实践中广泛采用IBD诊断之前.
相关概念视频
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
348
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
348
Inflammatory Bowel Disease IV: Pharmacological Management
145
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
145
Inflammatory Bowel Disease I: Ulcerative Colitis
207
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
207
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
181
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
181
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
164
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
164
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
186
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
186


