JNK通路相关磷酸酶水平变化在儿童炎症性肠病中的临床意义
Clinical Significance of the Level of Serum JNK Pathway-Associated Phosphatase in Children with Inflammatory Bowel Disease

本研究旨在探讨血清C-Jun N-末端激酶通路相关磷酸酶(C-Jun N-terminal kinase pathway-associated phosphatase, JKAP)水平在儿童炎症性肠病(Inflammatory Bowel Disease, IBD)中的表达及其与炎症轻重程度、疾病活动度、Th17细胞水平的相关性。方法：选取140例IBD患儿(包括60例克罗恩病(Crohn’s Disease, CD)儿童和80例溃疡性结肠炎(Ulcerative Colitis, UC)儿童)作为实验组，采用ELISA法检测其血清JKAP、TNF-α、IL-23、IFN-γ和IL-17A水平。同时，选取10名健康儿童作为对照者，ELISA法检测血清JKAP水平。结果：① 与健康对照组相比，CD儿童和UC儿童的血清JKAP水平降低(均p < 0.05)。② 在CD患儿中，JKAP水平与CRP (p = 0.016)和ESR (p = 0.029)呈负相关；在UC儿童中，JKAP也与CRP (p = 0.006)和ESR (p = 0.022)呈负相关。③ 血清JKAP水平与儿童克罗恩病活动指数(Pediatric Crohn’s Disease Activity Index, PCDAI) (p = 0.001)和儿童溃疡性结肠炎临床活动性指数(Pediatric ulcerative colitis activity index, PUCAI) (p = 0.002)呈负相关。④ 在CD和UC儿童中，血清JKAP水平与TNF-α呈负相关(均 p < 0.05)，与IL-23无明显相关性(均为p > 0.05)。⑤ 在CD或UC儿童中，JKAP与IFN-γ (Th1分泌细胞因子)无相关性(均为p > 0.05)。⑥ 在CD和UC儿童中，JKAP与IL-17A (Th17分泌细胞因子)呈负相关(均为p < 0.05)。结论：血清JKAP水平在IBD儿童中呈低表达，与炎症轻重程度、疾病活动度和Th17细胞分泌的细胞因子水平呈负相关。
The objective of this study was to investigate the expression of serum C-Jun N-terminal kinase pathway-associated phosphatase (JKAP) level in pediatric inflammatory bowel disease (IBD) and its correlation with inflammation, disease activity, and Th17. Methods: 140 children with IBD (including 60 children with Crohn’s Disease (CD) and 80 children with Ulcerative Colitis (UC) were selected for the serum levels of JKAP, TNF-α, IL-23, IFN-γ and IL-17A by ELISA. Meanwhile, 10 healthy children were selected as controls and serum JKAP levels were measured by ELISA. Results: ① Serum JKAP levels were reduced in CD children and UC children compared with healthy controls (all p < 0.05). ② In children with CD, JKAP levels were negatively associated with CRP (p = 0.016) and ESR (p = 0.029); In children with UC, JKAP was also negatively associated with CRP (p = 0.006) and ESR (p = 0.022). ③ Serum JKAP levels were negatively associated with Pediatric Crohn’s Disease Activity Index (PCDAI) (p = 0.001) and Pediatric ulcerative colitis activity index (PUCAI) (p = 0.002). ④ In children with CD and UC, serum JKAP levels were negatively associated with TNF-α (both p < 0.05), and no significant correlation with IL-23 (both p > 0.05). ⑤ There was no correlation between JKAP and IFN-γ (Th 1 secreted cytokines) in children with CD or UC (both p > 0.05). ⑥ JKAP was negatively correlated with IL-17A (Th17 secreted cytokine) in CD and UC children (both p < 0.05). Conclusion: JKAP shows low expression in IBD children and was negatively correlated with inflammation, disease activity, and Th17 cells.