IBD:黏膜嗜酸性粒细胞增多是维多珠单抗在炎症性肠病中治疗效果的独立预测因子

2020-08-03 MedSci原创 MedSci原创

在炎症性肠病(IBD)患者中,外周和粘膜嗜酸性粒细胞增多可能与更具侵略性的疾病表型有关。

背景

在炎症性肠病(IBD)患者中,外周和粘膜嗜酸性粒细胞增多可能与更具侵略性的疾病表型有关。维多珠单抗(Vedolizumab)可以阻断T淋巴细胞,嗜酸性粒细胞粘附和胃肠道外渗。因此黏膜嗜酸性粒细胞增多是否是维多珠单抗治疗效果的预测指标尚不清楚。本项研究旨在进行相关的研究明确这一现象。

 

方法

这是一项回顾性队列研究,研究对象为在开始使用维多珠单抗之前已停用类固醇的IBD患者。病理学家对所有患者的肠道活检标本进行了复查,并量化了嗜酸性粒细胞的平均密度。在开始使用维多珠单抗治疗6个月后,研究人员对患者的特征和临床缓解情况进行了统计分析。比较了无反应者和有反应者之间的特征,并进行了多变量logistic回归以确定临床反应的预测因素。

 

结果

在开始使用维多珠单抗治疗的251名IBD患者中,有65名患者(48%的克罗恩病,52%的溃疡性结肠炎)符合纳入标准。研究结果发现所有对维多珠单抗无反应的IBD患者更有可能具有更高的基线平均嗜酸性粒细胞计数(340±156 vs 236±124;P = 0.004),之前曾接受过抗TNF治疗(96%vs 56%;P = 0.001)也对维多珠单抗的有效性大打折扣,男性(58%比28%;P = 0.02)更加明显。UC无反应者在结肠活检中平均嗜酸性粒细胞计数显着增加(438±149 vs 299±145;P = 0.01)。在CD无反应者中也看到了类似的趋势。在多变量分析中,结肠嗜酸性粒细胞密度和先前的抗TNF暴露以及两者的结合是反应的独立预测因子。

 

结论

在溃疡性结肠炎中,结肠嗜酸性粒细胞增多和先前的抗TNF暴露是对维多珠单抗6个月临床无反应的独立预测因子。黏膜嗜酸性粒细胞密度作为一种新的生物标志物应在较大的患者队列中探索。

 

原始出处:

Erin M Kim. Et al. Mucosal Eosinophilia Is an Independent Predictor of Vedolizumab Efficacy in Inflammatory Bowel Diseases. Inflammatory Bowel Diseases.2020.

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    2020-08-05 bnurmamat
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1894168, encodeId=7f76189416875, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sat Jul 17 07:32:55 CST 2021, time=2021-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263586, encodeId=94bb12635861d, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310748, encodeId=88b31310e48e8, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324656, encodeId=f0cc13246564b, content=<a href='/topic/show?id=dad84023404' target=_blank style='color:#2F92EE;'>#嗜酸性粒细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40234, encryptionId=dad84023404, topicName=嗜酸性粒细胞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520069, encodeId=efe015200697b, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547357, encodeId=6ddf154e35754, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805938, encodeId=1b9880593867, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f345408567, createdName=ms1000001674122650, createdTime=Mon Aug 03 16:20:40 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032600, encodeId=f92710326007a, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047134, encodeId=d4ea104e13404, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1894168, encodeId=7f76189416875, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sat Jul 17 07:32:55 CST 2021, time=2021-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263586, encodeId=94bb12635861d, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310748, encodeId=88b31310e48e8, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324656, encodeId=f0cc13246564b, content=<a href='/topic/show?id=dad84023404' target=_blank style='color:#2F92EE;'>#嗜酸性粒细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40234, encryptionId=dad84023404, topicName=嗜酸性粒细胞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520069, encodeId=efe015200697b, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547357, encodeId=6ddf154e35754, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805938, encodeId=1b9880593867, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f345408567, createdName=ms1000001674122650, createdTime=Mon Aug 03 16:20:40 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032600, encodeId=f92710326007a, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047134, encodeId=d4ea104e13404, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-05 snowpeakxu
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1894168, encodeId=7f76189416875, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sat Jul 17 07:32:55 CST 2021, time=2021-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263586, encodeId=94bb12635861d, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310748, encodeId=88b31310e48e8, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324656, encodeId=f0cc13246564b, content=<a href='/topic/show?id=dad84023404' target=_blank style='color:#2F92EE;'>#嗜酸性粒细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40234, encryptionId=dad84023404, topicName=嗜酸性粒细胞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK17mLkWpia3T92NlEWTkEhrhZa7XPNic2JqQumEicZXGYFG6Ww5SCIl0Uq62bhhPnibAqIZDHtRva92A/132, createdBy=e0752500025, createdName=江川靖瑶, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520069, encodeId=efe015200697b, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547357, encodeId=6ddf154e35754, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Wed Aug 05 00:32:55 CST 2020, time=2020-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=805938, encodeId=1b9880593867, content=厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9f345408567, createdName=ms1000001674122650, createdTime=Mon Aug 03 16:20:40 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032600, encodeId=f92710326007a, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047134, encodeId=d4ea104e13404, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Aug 03 12:32:55 CST 2020, time=2020-08-03, status=1, ipAttribution=)]
    2020-08-03 ms1000001674122650

    厉害

    0

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    2020-08-03 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2020-08-03 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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有限的证据表明,低发酵低聚糖、二糖、单糖和多元醇(FODMAPs)饮食可以减少静止性炎症性肠病(IBD)的肠道症状。我们进行了一项随机对照试验,研究低FODMAP饮食对静止期IBD患者持续肠道症状、肠

IBD:炎症性肠病的疾病活动度与动脉血管疾病的发生有关

有证据表明,炎症性疾病与心血管风险增加有关。本项研究旨在评估这种风险,并针对常规血管危险因素和IBD疾病活动的影响进行验证。