Detection Of Urinary SCD14 Levels In Patients With Inflammatory Bowel Disease And Its Clinical Analysis

Objective: Inflammatory bowel disease(IBD)includes ulcerative colitis(UC)and crohn’s disease(CD).Generally,the course of IBD is long and it is easy to recurrent.Therefore,it needs to be repeated evaluating to guide the clinical diagnosis and treatment.But it lacks the easy operation,sensitivity and the higher specific evaluation index in clinic.IBD patients generally have intestinal microbiota dysbiosis and intestinal mucosal barrier damage,which result in high level of systemic circulating endotoxin.SCD14 is endotoxin-specific receptor protein,widely presents in the body circulatory system,which can be response to toxins level of the body accurately and the inflammation condition of intestinal mucosa.So this study aims to explore the clinical significance of urine sCD14 levels changes in the IBD patients.Methods: A total of 114 patients with clinically diagnosed IBD were enrolled from October 2015 to October 2016.Among them,49 cases were UC patients,with an average age of 44 years old(range from16 to 67 years),29 males and 20 females;65patients with CD,the average age was 37(range from 16 to 66 years),49 males and 16 females.The IBD diagnostic criteria refer to "China’s Diagnosis and Management of inflammatory bowel disease consensus opinion" of the Chinese Medical Association of Digestive Diseases Inflammatory Bowel Disease Group(2012 · Guangzhou).We also chose 30 normal cases as the healthy control group,and their average age was 30 years old(21-54 years).The urine and blood samples on the first day of admission and urine samples on the 3rd day after treatment were collected.The patients in healthy control group were collected with the blood and urine samples.The collected of urine specimens were added with preservative,then 5 ml of the mixture was placed at-80°C.The levels of sCD14 in urine and plasma samples in IBD group and healthy control group were detected by enzyme-linked immunosorbent assay(ELISA),and the clinical features were analyzed.Results:(1)The general information of IBD patients and healthy control group There were 114 cases of IBD patients,including 49 cases of UC patients and 65 cases of CD patients.Of UC patients,45 cases in active,and 4 cases in remission.9 cases were mild,17 cases were moderate and 19 cases were severe.Among them,there were 2cases of E1 type,17 cases of E2 type and 26 cases of E3 type.Of CD patients,31 cases in remission,29 cases were moderate,5 cases were severe.28 cases of L1 type,13 cases of L2 type and 24 cases of L3 type;There were 41 cases of B1 type,18 cases of B2 type,6 cases of B3 type;11 cases with complications;Of healthy control group,30 males and20 females were ranged from 21 to 54 years old.(2)The detection of sCD14 levels in urinary and plasma in IBD patients and healthy controlsCompare with the healthy group,the levels of sCD14 in the urine of the UC group were significantly higher(0.10±0.05ug/ml vs.0.36±0.11ug/ml;p <0.05).The levels of sCD14 in CD group were significantly higher than those in control group(0.30±0.06ug/ml vs.0.10±0.05ug/ml;p <0.05).The plasma sCD14 levels in UC group were significantly higher than those in healthy control group(7.4±1.43μg/ml vs.2.29±0.25ug/ml;p <0.05).CD group was significantly higher when compared with healthy control group(7.86±1.13ug/ml vs.2.29±0.25ug/ml;p <0.05).(3)Association analysis of sCD14 levels and clinical features in urine and blood of IBD patients The urine levels of sCD14 in remission of UC group were 0.31±0.05ug/ml,which were lower than those in active period.The levels of urine sCD14 in group E1,E2 and E3 were not reach the difference(p> 0.05).The levels of plasma sCD14 in patients with UC were 7.6±1.93ug/ml,which lower than those in active period of 7.38 ±0.44ug/ml(p>0.05).The difference in mild group,moderate group and severe group were not statistically significant(p>0.05),the same to the difference among group E1,E2 and E3(p>0.05).The urine sCD14 levels in remission of CD group were 0.29±0.05ug/ml and the active group were 0.31±0.07ug/ml(p<0.05).The urine sCD14 levels of in moderate active group were lower than those in severe group(p<0.05).The urine sCD14 levels among different lesion location were not reach the difference(p>0.05).In accordance with the different disease behavior,the difference of among groups were statistically significant(p <0.05).Similarly,the plasma sCD14 levels in remission of CD patients were7.90±1.18ug/ml,while active group 7.82 ± 1.15ug/ml,Moderate activity 8.04 ±0.96ug/ml,severe group 6.80±1.68ug/ml,and the difference of those groups were not statistically significant(p<0.05).The differences were not statistically significant among different lesion range groups(p> 0.05);according to disease behavior classification,the differences among the groups were statistically significant(p> 0.05).(4)The analysis of sCD14 levels between in urine and blood in IBD patients and CRP,ESR and Mayo/ CDAI score There were significantly correlation between sCD14 levels of urine and CRP levels in UC cases(r = 0.562,p<0.05),and there were no significant correlation with ESR and Mayo Score in UC patients.There were significantly correlation between sCD14 levels of urine and CDAI score in CD cases(r=0.305,p<0.05).SCD14 levels of urine had a certain correlation with the behavioral classification(r =0.281,p<0.05),but not with CPR and ESR.(5)Detection and comparison of urine sCD14 in IBD patients before and 3 days after treatmentBefore the treatment,the levels of urine sCD14 in UC group were 0.41±0.17ug/ml and0.28±0.06ug/ml,and in CD group were 0.30±0.06ug/ml and 0.25±0.06ug/ml.The difference between before and after treatment both in UC and CD group were significantly different(p<0.05).Conclusion:(1)The levels of sCD14 in urine and plasma in IBD patients were significantly higher than those in healthy controls.(2)The urinary sCD14 levels in patients with UC in remission were lower than those in active UC.The difference of urine sCD14 levels was not significant in the different severity and extent of disease.Urine sCD14 levels and CRP levels have a certain correlation in UC patients.(3)The urinary sCD14 levels in patients with CD in remission were lower than active CD.The difference of urine sCD14 level is not significant in different severity and extent of disease.The levels of sCD14 in CD patients were correlated with CDAI score,but not with CRP and ESR levels.(4)The Urine sCD14 levels had significant differences before and after therapy,which could be helpful to the evaluation indicators of clinical curative effect.