A Combined Set of Four Serum Inflammatory Biomarkers Reliably Predicts Endoscopic Disease Activity in Inflammatory Bowel Disease

Frontiers in Medicine

article

Arno R. Bourgonje¹  Rinze W. F. ter Steege²  Marijn C. Visschedijk¹  Rinse K. Weersma¹  Paul de Vos³  Klaas Nico Faber¹  Gerard Dijkstra¹  Julius Z. H. von Martels¹  Ruben Y. Gabriëls¹  Tjasso Blokzijl⁴  Manon Buist-Homan⁴  Janette Heegsma⁴  Bernadien H. Jansen⁴  Hendrik M. van Dullemen¹  Eleonora A. M. Festen¹ 

[1] Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen;Department of Gastroenterology and Hepatology, Martini Hospital;Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen;Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen

关键词: Inflammatory Bowel Disease (IBD);    inflammatory biomarkers;    endoscopy;    inflammation;    disease activity;   

DOI  :  10.3389/fmed.2019.00251

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Blood C-reactive protein (CRP) and fecal calprotectin levels are routinely measured as surrogate markers of disease activity in Inflammatory Bowel Disease (IBD), but often do not correlate well with the degree of mucosal inflammation in the intestine as established by endoscopy. Therefore, novel predictive biomarkers are urgently needed that better reflect mucosal disease activity in IBD. The aim of this study was to identify a combination of serum inflammatory biomarkers predictive for endoscopic disease activity. Methods: Serum concentrations of 10 inflammatory biomarkers were analyzed in 118 IBD patients [64 Crohn's disease (CD), 54 ulcerative colitis (UC)] and 20 healthy controls. In a subset of 71 IBD patients, endoscopic disease activity was established. Non-parametric ROC estimation with bootstrap inference was used to establish the best combination of inflammatory biomarkers predicting endoscopic disease activity. Results: Six (6) inflammatory biomarkers (serum amyloid A (SAA), Eotaxin-1, IL-6, IL-8, IL-17A, and TNF-α) showed better prediction of IBD disease activity than routine measures (CRP, fecal calprotectin and HBI/SCCAI scores). The best combination of predictive inflammatory biomarkers consisted of serum SAA, IL-6, IL-8, and Eotaxin-1, showing an optimism-adjusted area under the ROC (AuROC) curve of 0.84 (95% CI: 0.73–0.94, P < 0.0001), which predicted significantly better ( P = 0.002) than serum CRP levels with an AuROC of 0.57 (95% CI: 0.43–0.72, P = 0.32). Conclusion: The combination of SAA, IL-6, IL-8, and Eotaxin-1 reliably predicts endoscopic disease activity in IBD and might be valuable for monitoring disease activity and management of the disease.

【 授权许可】

CC BY