炎症性肠病患者外周血白细胞介素-22、基质金属蛋白酶-9、巨噬细胞移动抑制因子表达及其临床意义

Expressions and Significance of Interleukin-22,Matrix Metalloproteinase-9 and Macrophage Migration Inhibitory Factor in Peripheral Blood of Patients with Inflammatory Bowel Disease

背景:近年来炎症性肠病(IBD)的发病率呈上升趋势,其发病机制尚未完全阐明。目的:探讨IBD患者外周血白细胞介素-22(IL-22)、基质金属蛋白酶-9(MMP-9)、巨噬细胞移动抑制因子(MIF)表达及其临床意义。方法:纳入2011年5月-2014年11月苏州大学附属第一医院收治的IBD患者80例,其中克罗恩病(CD)43例,溃疡性结肠炎(UC)37例;健康体检者40名作为正常对照组。采用ELISA法检测外周血IL-22、MMP-9、MIF表达水平,对CD和UC活动期IL-22、MMP-9、MIF表达水平行多因素Logistic回归分析,并以ROC曲线评价IL-22、MMP-9、MIF筛查CD和UC活动期的诊断性能。结果:CD组和UC组外周血IL-22、MMP-9、MIF表达水平较正常对照组显著升高(P<0.05),CD组与UC组间差异无统计学意义(P>0.05)。CD和UC活动期外周血IL-22、MMP-9、MIF表达水平较缓解期显著升高(P<0.05);IL-22、MMP-9联合检测筛查IBD活动期的ROC曲线下面积(AUC)(CD:0.853,UC:0.867)优于IL-22、MMP-9、MIF三项指标单独检测(CD:0.747、0.770和0.699,UC:0.774、0.815和0.761)。结论:IBD患者外周血IL-22、MMP-9、MIF表达水平显著升高,且与疾病活动性密切相关。IL-22、MMP-9联合检测有利于提高IBD活动期筛查的准确性。

Background： The incidence of inflammatory bowel disease（ IBD） is increasing recently. However,the pathogenesis has not been fully clarified. Aims： To investigate the expressions and significance of interleukin-22（ IL-22）,matrix metalloproteinase-9（ MMP-9） and macrophage migration inhibitory factor（ MIF） in peripheral blood of patients with IBD.Methods： A total of 80 patients with IBD admitted from May 2011 to Nov. 2014 at the First Affiliated Hospital of Soochow University were enrolled,in which 43 cases were Crohn＇s disease（ CD）,37 cases were ulcerative colitis（ UC）. Forty healthy subjects were served as normal controls. Peripheral levels of IL-22,MMP-9 and MIF were detected by ELISA.Multivariate Logistic regression model was used to analyze IL-22,MMP-9 and MIF in active CD and UC and ROC curve was used to evaluate the diagnostic performance of these markers for screening of active CD and UC. Results： Compared with normal control group,peripheral levels of IL-22,MMP-9 and MIF increased significantly in CD and UC groups（ P〈0. 05）,while no significant difference was found between CD and UC groups（ P〉0. 05）. Peripheral levels of IL-22,MMP-9 and MIF in active CD and UC were significantly higher than those in remission stage（ P〈0. 05）. For screening of active IBD,the area under ROC curve（ AUC） of combined detection of IL-22 and MMP-9（ 0. 853 for CD,0. 867 for UC）was superior to that of IL-22,MMP-9 or MIF only（ 0. 747,0. 770 and 0. 699 for CD,0. 774,0. 815 and 0. 761 for UC）.Conclusions： Peripheral levels of IL-22,MMP-9 and MIF increase markedly in IBD patients,which are correlated closely with the activity of IBD. Combined detection of IL-22 and MMP-9 might greatly increase the accuracy for screening of active IBD.