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要旨●現在,炎症性腸疾患(IBD)の疾患活動性を把握しうるゴールドスタンダードは内視鏡検査である.しかしながら,内視鏡検査は患者への侵襲性やコストが高いことから,外来受診ごとに施行することは非現実的であり,より鋭敏かつ簡便に疾患活動性をモニタリングできるバイオマーカーが求められている.近年,便中カルプロテクチンと血清ロイシンリッチα2グリコプロテインが保険収載され,既存のC反応性蛋白に加えて非侵襲的にIBDの病勢をモニタリングするツールが増えてきている.今後はこれらを活用して,より正確にIBDの病勢を把握する戦略を確立することが求められる.
Endoscopy is the current gold standard for monitoring disease activity in patients with IBD(inflammatory bowel disease). However, due to its invasiveness and high cost, it is not practical to perform endoscopy at every outpatient visit, and thus, biomarkers that can monitor disease activity more sensitively and easily are needed. Recently, fecal calprotectin and serum leucine-rich alpha-2 glycoprotein have been included in the insurance coverage in Japan, and in addition to the conventional marker C-reactive protein, the availability of non-invasive tools for monitoring IBD disease activity is increasing. It will be necessary to establish a rigorous strategy to utilize these biomarkers alone or in combination for more accurate monitoring of IBD disease activity.
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