在患有活性性结肠炎的患者中,细胞巨乳病毒结肠再激活的预测因素
Alexandre Jentzer1, Aymeric Cantais1, Xavier Roblin1,2
1CIRI-Centre International de Recherche en Infectiologie (GIMAP Team, University of Lyon, Univerity of Saint-Etienne, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1), Cedex 02, 42218 Saint-Etienne, France.
Viruses
|April 26, 2025
概括
在性结肠炎 (UC) 中的细胞巨乳病毒 (CMV) 大肠炎很难诊断. 梅奥内镜评分为2或更高预测UC患者的CMV重新激活,而抗TNFα治疗可能会降低风险.
科学领域:
- 胃肠病学 胃肠病学
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 细胞巨乳病毒 (CMV) 相关性结肠炎对性结肠炎 (UC) 患者产生负面影响.
- 诊断CMV大肠炎涉及侵入性和昂贵的内镜活检检测病毒标记物.
- 在耐固醇性UC的急性发作中,CMV大肠炎的发生率不到30%.
研究的目的:
- 在性结肠炎 (UC) 患者中确定CMV再激活的非侵入性预测因素.
- 分析患者的特征,疾病活性和与CMV重新激活相关的免疫抑制治疗.
主要方法:
- 在法国圣埃蒂安大学医院2014-2019年间对173名UC患者进行了回顾性研究.
- 收集患者数据,包括疾病活性,免疫抑制治疗和CMV DNA负载.
- 使用多变量分析来识别与CMV重新激活相关的因素.
主要成果:
- 梅奥内镜评分≥2是CMV阳性UC患者中CMV大肠炎的显著预测因子 (OR2.553,p=0.004).
- 生物参数没有显示CMV重新激活的预测价值.
- 抗TNFα单克隆抗体的使用与CMV重新激活的风险降低有关 (OR 0.384,p=0.035).
结论:
- 内镜评估,特别是梅奥内镜评分,对于预测UC中CMV活性化至关重要.
- 虽然抗TNFα疗法可能会降低风险,但肠道活检对于诊断CMV大肠炎和评估UC患者的疾病活性至关重要.
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