粪便基质金属蛋白酶9及其相关蛋白在婴儿食物过敏中的诊断价值  

Diagnostic value of fecal matrix metalloproteinase 9 and its related proteins for food allergy in infants

作　　者：高亚娟[1] 代妮妮 张华[2] 李在玲[1] GAO Yajuan;DAI Nini;ZHANG Hua;LI Zailing(Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China;Epidemiology Research Center,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院儿科,北京100191 [2]北京大学第三医院流行病学研究中心,北京100191

出　　处：《临床儿科杂志》2024年第7期619-625,共7页Journal of Clinical Pediatrics

基　　金：北京大学医学部大健康国际研究院项目(No.JKCJ202301);北京大学第三医院临床队列建设项目(No.BYSYDL2022019)。

摘　　要：目的探索基质金属蛋白酶9(MMP9)及其相关蛋白在婴儿食物过敏(FA)中的诊断价值。方法本研究为巢式病例对照研究,连续纳入2023年4月至2023年10月疑诊FA的婴儿,收集粪便,经口服食物激发试验将入组婴儿分为FA组和非FA组。通过酶联免疫吸附测定法测定粪便MMP9、基质金属蛋白酶组织抑制剂1(TIMP 1)和脂质运载蛋白2(LCN 2)的浓度,通过对比粪便总蛋白浓度计算其相对含量,通过受试者工作曲线的曲线下面积(AUC)、灵敏度、特异度等指标评价目标蛋白诊断婴儿FA的准确度。二元logistic回归筛选FA预测因子。结果共纳入FA组69例及非FA组72例。粪便MMP9及TIMP 1浓度诊断FA的AUC值分别为0.82和0.78,MMP9及TIMP 1相对含量的AUC值分别增加至0.85及0.83。LCN 2诊断价值不佳。多因素logistic回归提示粪便MMP 9是FA的最佳预测指标。结论粪便MMP 9和TIMP 1是诊断婴儿FA的有用工具,可以很好的区分FA及类似疾病。Objective To explore the diagnostic value of matrix metalloproteinase 9(MMP 9)and its related proteins for food allergy(FA)in infants.Methods This nested case-control study enrolled infants with suspected FA from April to October 2023.Infant feces were collected and the infants were divided into FA group and nonFA group according to the results of oral food challenges.The fecal MMP 9,tissue inhibitor of metalloproteinase 1(TIMP 1)and lipocalin 2(LCN 2)were measured by enzyme-linked immunosorbent assay,and the relative content was calculated.The area under the ROC curve(AUC),sensitivity and specificity were used to evaluate the accuracy of the target proteins in the diagnosis of infantile FA.We assessed the diagnose value by area under the curve(AUC),sensitivity and specificity.The predictors of FA were screened by binary logistic regression analysis.Results A total of 69 patients in the FA group and 72 patients in the non-FA group were included.The AUC values of fecal MMP 9 and TIMP 1 concentrations for the diagnosis of FA were 0.82 and 0.78,respectively,and the AUC values of the relative contents of MMP 9 and TIMP 1 were increased to 0.85 and 0.83,respectively.The diagnostic value of LCN 2 is poor.Binary multivariate logistic regression analysis suggested that fecal MMP 9 was the best predictor of FA.Conclusion Fecal MMP 9 and TIMP 1 are useful diagnostic tools for FA in infants,and can distinguish FA from other similar diseases.

关 键 词：食物过敏 基质金属蛋白酶9 脂质运载蛋白2 基质金属蛋白酶组织抑制剂1 婴儿 

分 类 号：R725.9[医药卫生—儿科]