Bile acid alterations associated with indolent course of inflammatory bowel disease

The indolent course of treatment-naive patients with inflammatory bowel disease (IBD) is confirmed predictable based on clinical characteristics. Current evidences supported that bile acids (BAs) alteration might be promising biomarkers in the field of IBD. We aimed to analyze the alterations of BAs as the disease progresses and explore their predictive value for indolent course of IBD. The indolent course of IBD was defined as a disease course without need for strict interventions throughout the entire follow-up. A targeted metabolomics method was used to detect the concentration of 27 BAs from serum sample in treatment-naive patients with IBD (Crohn’s disease [CD], <i>n</i> = 27; ulcerative colitis [UC], <i>n</i> = 50). Patients with CD and UC were individually divided into two groups for further study according to the median time of indolent course. The overall BAs profile and the clinical value of BAs in predicting indolent course of IBD were identified between different groups. For CD, the levels of deoxycholic acid, glycodeoxycholic acid, taurodeoxycholic acid, glycolithocholic acid-3-sulfate disodium salt and iso-lithocholic acid were significantly increased in patients with indolent course &gt; 18 M (<i>p</i> &lt; 0.05). These five BAs owned 83.5% accuracy for predicting indolent course over 18 months in CD. For UC, the concentration of deoxycholic acid and glycodeoxycholic acid were significantly higher, while dehydrocholic acid were lower in patients with indolent course &gt; 48 M (<i>p</i> &lt; 0.05). These three BAs predicted indolent course over 48 months of 69.8% accuracy in UC. The specific BAs alterations might be potential biomarkers in predicting disease course of IBD patients.

基于临床特征，初治炎症性肠病（IBD）患者的惰性病程已被证实具备可预测性。现有研究证据表明，胆汁酸（BAs）谱异常有望成为IBD领域极具潜力的生物标志物。本研究旨在分析疾病进展过程中胆汁酸的变化特征，并探讨其对IBD惰性病程的预测价值。本研究将IBD惰性病程定义为：在整个随访周期内无需接受强化干预措施的疾病进程。本研究采用靶向代谢组学方法，对初治IBD患者（克罗恩病[CD]，n=27；溃疡性结肠炎[UC]，n=50）的血清样本中27种胆汁酸的浓度进行检测。研究人员分别根据惰性病程的中位时长，将CD患者与UC患者各分为两组以开展后续分析。通过对比不同分组，明确了整体胆汁酸谱特征以及胆汁酸在预测IBD惰性病程中的临床应用价值。在CD患者中，惰性病程超过18个月的患者，其脱氧胆酸、糖基脱氧胆酸、牛磺脱氧胆酸、3-硫酸糖基石胆酸二钠盐以及异石胆酸的水平显著升高（p<0.05）。上述五种胆汁酸对CD患者18个月以上惰性病程的预测准确率可达83.5%。在UC患者中，惰性病程超过48个月的患者，其脱氧胆酸与糖基脱氧胆酸的浓度显著升高，而去氢胆酸的浓度则显著降低（p<0.05）。上述三种胆汁酸对UC患者48个月以上惰性病程的预测准确率可达69.8%。上述特异性胆汁酸变化有望成为预测IBD患者疾病进程的潜在生物标志物。