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Blood chemistry markers for evaluation of inflammatory activity in Crohns disease during infliximab therapy
Karolinska University Hospital.
Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
Karolinska University Hospital.
Merck Sharp and Dohme Ltd.
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2011 (English)In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, ISSN 0036-5521, Vol. 46, no 4, 420-427 p.Article in journal (Refereed) Published
Abstract [en]

Objective. There is a discrepancy between clinical activity and biomarkers in inflammatory bowel disease. The Harvey--Bradshaw index (HBi) is steadfast to evaluate disease activity. A set of biological markers (high sensitive C-reactive protein [hs-CRP], calprotectin, total nitrite, soluble urokinase Plasminogen Activator Receptor [suPAR], ghrelin and endothelin) are investigated to study inflammatory activity and correlation with HBi during infliximab therapy. Material and methods. Patients with Crohnsdisease (n == 22) were assessed and blood samples drawn before and 1 week after infliximab infusion (5 mg/kg) and repeated after 6 months, and compared to healthy volunteers. Hs-CRP, calprotectin, suPAR, ghrelin and endothelin were analyzed with immunoassays, and total nitrite with Griess-reaction. Results were analyzed with Wilcoxon matched-pairs test, Mann--Whitney test and Spearman correlations. Results. After the first infusion visit, HBi and calprotectin values decreased while nitrite increased (p andlt; 0.05). At the 6-month visit, pre-infusion index and biomarkers had returned to baseline levels. Post-infusion, again the values of HBi, hs-CRP and calprotectin decreased (p andlt; 0.05). The suPAR levels did not change between pre- and post-infusion periods at either visit. Calprotectin, nitrite and suPAR differed from healthy controls throughout the study (p andlt; 0.05). Endothelin decreased with each treatment but was, like ghrelin, not different from controls. We found HBi to correlate with hs-CRP (Spearman r == 0.32, p andlt; 0.05), but calprotectin did not, neither did nitrate nor suPAR. Conclusions. Although infliximab ameliorates Crohnsdisease symptoms, inflammatory markers are not persistently normalized, indicating a chronic inflammatory condition that may require continued infliximab therapy.

Place, publisher, year, edition, pages
Informa Healthcare , 2011. Vol. 46, no 4, 420-427 p.
Keyword [en]
Biological treatment, biomarkers, Harvey-Bradshaw index, inflammatory bowel disease
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-67007DOI: 10.3109/00365521.2010.539253ISI: 000288170600006OAI: diva2:406261
Available from: 2011-03-25 Created: 2011-03-25 Last updated: 2011-04-21

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Theodorsson, Elvar
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Clinical ChemistryFaculty of Health SciencesDepartment of Clinical Chemistry
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