炎症性肠病血清学标志物的研究进展

doi:10.3969/j.issn.1673-8640.2018.02.016

摘要/Abstract

摘要：

炎症性肠病（IBD）是一种病因不明的慢性肠道炎性疾病,包括克罗恩病（CD）和溃疡性结肠炎（UC）。当前IBD的诊断基于内窥镜下特点和组织病理学表现,但检查为侵入性且操作复杂。寻找一种简单、无创、敏感、经济、快速的方法来应用于IBD的诊断及病情评估成为目前亟待解决的问题,因此关于IBD的特异性血清学标志物已成为IBD的研究热点。文章结合国内外IBD领域的新近研究,对一些传统的血清学标志物的新进展以及最新发现的标志物,如抗酶原颗粒膜糖蛋白2（GP2）抗体、抗CUB和带状疱疹透明区样域蛋白1（CUZD1）抗体、巨噬细胞凋亡抑制因子（AIM）、血清源性透明质酸相关蛋白（SHAP）等进行介绍。

关键词: 血清学标志物, 炎症性肠病, 溃疡性结肠炎, 克罗恩病

Abstract:

Inflammatory bowel disease（IBD）,including Crohn's disease（CD） and ulcerative colitis（UC）,is a chronic intestinal inflammation of unknown etiology. At present,the diagnosis of IBD is confirmed mainly by endoscopy and histopathologic examination of biopsies,and the invasiveness and difficult operations of such inspections make it necessary to find a non-invasive method that is more convenient,sensitive,affordable and efficient. Serological biomarkers may meet this demand and has become a focus of IBD research. This review summarizes recent research progress in the field of IBD,advance in traditional markers and some new types of markers such as anti-glycoprotein 2（GP2） antibody,anti-CUB and zona pellucida-like domain-containing protein 1（CUZD1） antibody,apoptosis inhibitor of macrophage（AIM） and serum-derived hyaluronan-associated protein（SAHP）.

Key words: Serological biomarker, Inflammatory bowel disease, Ulcerative colitis, Crohn's disease

中图分类号:

R446.62

曾俊祥, 潘秀军, 沈立松. 炎症性肠病血清学标志物的研究进展[J]. 检验医学, 2018, 33(2): 170-176.

ZENG Junxiang, PAN Xiujun, SHEN Lisong. Research progress of serological biomarkers for inflammatory bowel disease[J]. Laboratory Medicine, 2018, 33(2): 170-176.

图/表 1

参考文献 31

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标志物	可能的靶抗原	阳性率			临床意义
		CD（%）	UC（%）	对照（%）	诊断/鉴别诊断	疾病表型/风险评估	预后/疗效评估	探究发病机制	指导治疗	参考
		CD（%）	UC（%）	对照（%）	诊断/鉴别诊断	疾病表型/风险评估	预后/疗效评估	探究发病机制	指导治疗	文献
ap-ANCA	中性粒细胞胞浆	2~28	45~82	<5	+	-	-	+	-	[6]
ap-ANCA	成分	2~28	45~82	<5	+	-	-	+	-	[6]
抗HMGB1	高迁移率族蛋白	27~34	2~24	0	-	+	-	+	-	[8]
抗体	B1	27~34	2~24	0	-	+	-	+	-	[8]
抗GP2抗体	PG2	0~45	2~12	1~8	+	-	-	+	-	[13]
抗CUZD1	人CUZD1	20.8~26.0								[15]
抗体	人CUZD1	20.8~26.0								[15]
GAB	小肠上皮杯状细胞	2~33	16~46	0	+	-	-	-	-	[16]
抗GM-CSF	GM-CSF				-	+	-	+	-	[19]
抗体	GM-CSF				-	+	-	+	-	[19]
ASCA	酿酒酵母细胞壁上	50~80	5~15	1~7	+	-	-	+	-	[22]
ASCA	磷酸肽甘露聚糖的甘露糖序列	50~80	5~15	1~7	+	-	-	+	-	[22]
ALCA	β-1-3多聚糖家族	20~25	4~9	2~12	+	+	-	-	+	[22]
ALCA	中“昆布多糖”	20~25	4~9	2~12	+	+	-	-	+	[22]
ACCA	N-乙酰-β-D 氨基	9~27	3~7	4~12	+	+	-	-	+	[22]
	葡糖聚合物“壳
	质”构的主要成
	成分之一
AMCA	甘露二糖	12~27	3~7	4~12	+	+	-	-	+	[22]
anti-L	昆布多糖	18~26	3~7	1~10	+	-	-	-	-	[22]
anti-C	壳质多糖	10~25	3~11	2~12						[22]
抗OmpC	大肠埃希菌外膜孔道C转运蛋白	24~55	2~24	0~5	+	+	-	+	-	[25]
抗体	大肠埃希菌外膜孔道C转运蛋白	24~55	2~24	0~5	+	+	-	+	-	[25]
抗I2抗体	荧光假单胞菌相关	38~60	2~10	4~8	+	+	+	-	+	[26]
抗I2抗体	序列I2	38~60	2~10	4~8	+	+	+	-	+	[26]
抗CBir1	细菌鞭毛蛋白CBir1	50~57	6~16	8~15	-	+	-	-	-	[27]
抗体	细菌鞭毛蛋白CBir1	50~57	6~16	8~15	-	+	-	-	-	[27]
抗A4-Fla2	细菌鞭毛蛋白A4-	59	6		-	-	-	-	-	[23]
抗体	Fla2	59	6		-	-	-	-	-	[23]
抗Fla-X	细菌鞭毛蛋白Fla-X	57	6
抗体	细菌鞭毛蛋白Fla-X	57	6
抗MAP	MAP	46~64	33~39	3~10	+	-	-	-	+	[29]
抗体	MAP	46~64	33~39	3~10	+	-	-	-	+	[29]
AIM		76.3			+	-	-	-	-	[30]
SHAP					-	-	+	-	-	[31]

标志物	可能的靶抗原	阳性率			临床意义
		CD（%）	UC（%）	对照（%）	诊断/鉴别诊断	疾病表型/风险评估	预后/疗效评估	探究发病机制	指导治疗	参考
		CD（%）	UC（%）	对照（%）	诊断/鉴别诊断	疾病表型/风险评估	预后/疗效评估	探究发病机制	指导治疗	文献
ap-ANCA	中性粒细胞胞浆	2~28	45~82	<5	+	-	-	+	-	[6]
ap-ANCA	成分	2~28	45~82	<5	+	-	-	+	-	[6]
抗HMGB1	高迁移率族蛋白	27~34	2~24	0	-	+	-	+	-	[8]
抗体	B1	27~34	2~24	0	-	+	-	+	-	[8]
抗GP2抗体	PG2	0~45	2~12	1~8	+	-	-	+	-	[13]
抗CUZD1	人CUZD1	20.8~26.0								[15]
抗体	人CUZD1	20.8~26.0								[15]
GAB	小肠上皮杯状细胞	2~33	16~46	0	+	-	-	-	-	[16]
抗GM-CSF	GM-CSF				-	+	-	+	-	[19]
抗体	GM-CSF				-	+	-	+	-	[19]
ASCA	酿酒酵母细胞壁上	50~80	5~15	1~7	+	-	-	+	-	[22]
ASCA	磷酸肽甘露聚糖的甘露糖序列	50~80	5~15	1~7	+	-	-	+	-	[22]
ALCA	β-1-3多聚糖家族	20~25	4~9	2~12	+	+	-	-	+	[22]
ALCA	中“昆布多糖”	20~25	4~9	2~12	+	+	-	-	+	[22]
ACCA	N-乙酰-β-D 氨基	9~27	3~7	4~12	+	+	-	-	+	[22]
	葡糖聚合物“壳
	质”构的主要成
	成分之一
AMCA	甘露二糖	12~27	3~7	4~12	+	+	-	-	+	[22]
anti-L	昆布多糖	18~26	3~7	1~10	+	-	-	-	-	[22]
anti-C	壳质多糖	10~25	3~11	2~12						[22]
抗OmpC	大肠埃希菌外膜孔道C转运蛋白	24~55	2~24	0~5	+	+	-	+	-	[25]
抗体	大肠埃希菌外膜孔道C转运蛋白	24~55	2~24	0~5	+	+	-	+	-	[25]
抗I2抗体	荧光假单胞菌相关	38~60	2~10	4~8	+	+	+	-	+	[26]
抗I2抗体	序列I2	38~60	2~10	4~8	+	+	+	-	+	[26]
抗CBir1	细菌鞭毛蛋白CBir1	50~57	6~16	8~15	-	+	-	-	-	[27]
抗体	细菌鞭毛蛋白CBir1	50~57	6~16	8~15	-	+	-	-	-	[27]
抗A4-Fla2	细菌鞭毛蛋白A4-	59	6		-	-	-	-	-	[23]
抗体	Fla2	59	6		-	-	-	-	-	[23]
抗Fla-X	细菌鞭毛蛋白Fla-X	57	6
抗体	细菌鞭毛蛋白Fla-X	57	6
抗MAP	MAP	46~64	33~39	3~10	+	-	-	-	+	[29]
抗体	MAP	46~64	33~39	3~10	+	-	-	-	+	[29]
AIM		76.3			+	-	-	-	-	[30]
SHAP					-	-	+	-	-	[31]