Blood chemistry markers for evaluation of inflammatory activity in Crohns disease during infliximab therapy
2011 (English)In: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, ISSN 0036-5521, Vol. 46, no 4, 420-427 p.Article in journal (Refereed) Published
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.
Biological treatment, biomarkers, Harvey-Bradshaw index, inflammatory bowel disease
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-67007DOI: 10.3109/00365521.2010.539253ISI: 000288170600006OAI: oai:DiVA.org:liu-67007DiVA: diva2:406261