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

doi:10.12372/jcp.2024.24e0033

Abstract

Abstract:

Objective To explore the diagnostic value of matrix metalloproteinase 9 (MMP9) 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 non-FA group according to the results of oral food challenges. The fecal MMP9, tissue inhibitor of metalloproteinase 1(TIMP1) and lipocalin 2(LCN2) 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 MMP9 and TIMP1 concentrations for the diagnosis of FA were 0.82 and 0.78, respectively, and the AUC values of the relative contents of MMP9 and TIMP1 were increased to 0.85 and 0.83, respectively. The diagnostic value of LCN2 is poor. Binary multivariate logistic regression analysis suggested that fecal MMP9 was the best predictor of FA. Conclusion Fecal MMP9 and TIMP1 are useful diagnostic tools for FA in infants, and can distinguish FA from other similar diseases.

Key words: food allergy, matrix metalloproteinase 9, lipocalin 2, tissue inhibitor of metalloproteinase 1, infant

GAO Yajuan, DAI Nini, ZHANG Hua, LI Zailing. Diagnostic value of fecal matrix metalloproteinase 9 and its related proteins for food allergy in infants[J].Journal of Clinical Pediatrics, 2024, 42(7): 619-625.

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References 40

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项目	FA组(n=69)	非FA组(n=72)	统计量	P
年龄M(P₂₅~P₇₅)/月	4.00(2.67~5.53)	4.27(3.93~6.07)	Z=1.32	0.188
性别[n(%)]			χ²=3.08	0.079
男	32(46.38)	44(61.11)
女	37(53.62）	28(38.89）
出生胎龄[M(P₂₅~P₇₅)]/周	39.43(38.71~40.00)	39.43(39.00~40.00)	Z=0.64	0.525
出生身长[M(P₂₅~P₇₅)]/cm	50.00(48.00~51.00)	50.00(48.00~51.00)	Z=1.54	0.117
出生体重[M(P₂₅~P₇₅)]/kg	3.40(3.10~3.60)	3.20(3.00~3.50)	Z=1.11	0.264
剖宫产[n(%)]	32(46.38)	32(44.44)	χ²=0.05	0.818

粪便蛋白	FA组	非FA组	Z值	P
MMP9/ng·mL^-1	8.67(3.95~15.72)	1.49(0.69~3.10)	6.56	<0.001
TIMP/ng·mL^-1	0.82(0.74~1.09)	0.56(0.54~0.74)	5.78	<0.001
LCN2/μg·mL^-1	4.89(2.52~7.80)	3.14(1.65~5.55)	2.90	0.004
粪便总蛋白浓度/mg·mL^-1	1.35(0.98~1.88)	2.32(1.55~3.09)	5.14	<0.001
MMP9相对含量/×10^-6	5.96(2.69~12.49)	0.77(0.19~1.69)	7.09	<0.001
TIMP1相对含量/×10^-6	0.62(0.41~1.08)	0.27(0.16~0.44)	6.57	<0.001
LCN2 相对含量/%	0.35(0.17~0.71)	0.15(0.06~0.25)	4.75	<0.001

粪便蛋白	AUC	灵敏度	特异度	约登指数	最佳阈值
MMP9	0.82	0.80	0.78	0.58	3.58 ng·mL^-1
TIMP1	0.78	0.96	0.49	0.44	0.55 ng·mL^-1
LCN2	0.64	0.59	0.67	0.26	4.17 μg·mL^-1
MMP9相对含量	0.85	0.75	0.83	0.58	2.69×10^-6
TIMP1相对含量	0.82	0.68	0.83	0.51	0.51
LCN2相对含量	0.73	0.59	0.79	0.39	0.28%

变量	β	SE	χ²值	P	OR	95%CI
MMP9	0.18	0.05	3.65	<0.001	1.19	1.09~1.32
TIMP1	1.30	0.78	1.67	0.094	3.67	0.89~19.27
LCN2	0.002	0.02	0.10	0.921	1.01	0.97~1.04

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

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