「Long pentraxin PTX3 is a good inflammation marker in the patients with inflammatory bowel diseases」
加藤 真吾先生（埼玉医科大学 総合医療センター 講師）
Shingo Kato-1, Masataka Ito-2, Kyoko Takeuchi-2, Junko Imaki-2, Kazuro Itoh-3, Koji Yakabi-1
1: Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, 2: Department of Developmental Anatomy and Regenerative Biology, 3: Department of Internal Medicine, National Defense Medical College
Backgrounds & Aims: Inflammation has a pathogenic role in inflammatory bowel diseases (IBD). CRP, short pentraxin C-reactive protein, is often used in the evaluation of inflammatory status in IBD. However, usually serum CRP level does not increase in active ulcerative colitis because the short pentraxin CRP is produced mainly by the liver in response to interleukin (IL)-6, as well as IL-6 level is not so high in patients with ulcerative colitis. Good inflammation marker is needed in the treatment of patients with IBDs. Pentraxin-3 (PTX3) is a prototypic long pentraxin mainly by dendritic cells, macrophages and endothelial cells in response to primary inflammatory stimuli. The aims of this study were to investigate the expression of PTX3 and evaluation of PTX3 as an inflammation marker in IBDs.
Materials & Methods: Immunohistochemistry; PTX3-immunoreactivity was examined in operated specimens from three UC patients, four CD patients and three colon cancer patients as normal controls. Primary antibody against PTX-3, CD45RO (UCHL-1), CD20 (L26) and myeloperoxidase were used. Plasma PTX3 levels were examined in 17 UC patients, 25 CD patients and 6 normal controls by ELISA. Mayo Scoring system was used to evaluate disease activity in UC patients, as well as IOIBD score were also used in CD patients.
Results: PTX3-immunoreactivity was recognized in the infiltrating cells containing lymphocytes, neutrophils and vessels in the inflamed gut. Total Mayo score was successfully examined in 15 UC patients, as well as partial Mayo score was examined in 17 UC patients. There was more significant correlation between partial Mayor score and plasma PTX3 concentration (r=0.63, p<0.01) than between partial Mayor score and serum CRP concentration (r=0.51, p<0.05) in UC patients. Sensitivity and specificity of plasma PTX3 concentration against disease activity were 91% and 75% in UC patients. However, sensitivity and specificity of serum CRP concentration were 45% and 100%. In contrast, there was a significant correlation between IOIBD score and plasma PTX3 concentration (r=0.49, p<0.01), as well as there was a significant correlation between IOIBD score and serum CRP concentration (r=0.61, p<0.01). Sensitivity and specificity of plasma PTX3 concentration against diseases activity were 71% and 62% in CD patients, as well as sensitivity and specificity of serum CRP concentration were 71% and 56%.
Conclusions: PTX3 is directly produced from inflamed gut in IBDs. Plasma PTX3 concentration is a good inflammation marker in IBD patients, especially in UC.
The American Association for the Study of Liver Diseases (AASLD)
The American Gastroenterological Association (AGA)
The American Society for Gastrointestinal Endoscopy (ASGE)
The Society for Surgery of the Alimentary Tract (SSAT)