Correlation of Erythrocyte Sedimentation Rate and C‐Reactive Protein With Pediatric Inflammatory Bowel Disease Activity

Alper, Arik; Zhang, Lucy; Pashankar, Dinesh S.

doi:10.1097/mpg.0000000000001444

Cited by 41 publications

(29 citation statements)

References 10 publications

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“…A post hoc analysis of a prospective clinical trial showed that CRP levels failed to discriminate between patients in clinical remission, with endoscopic inflammation and with mucosal healing (88). In pediatric patients with UC, neither marker was found to be useful in predicting clinical, endoscopic, or histological UC disease activity (89).…”

Section: Resultsmentioning

confidence: 99%

A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review

et al. 2019

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OBJECTIVES: In 2015, the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program proposed shifting the therapeutic focus on ulcerative colitis (UC) toward altering the natural history of the disease course by regularly monitoring objective measurements of disease activity and tailoring treatment accordingly. The therapeutic paradigm shift was well received in the research community and is often cited. However, new evidence on optimal UC treatment targets continues to accumulate since the time of the STRIDE guidelines. This systematic review summarizes the evidence accrued since the STRIDE UC recommendations, discusses the barriers for adoption of treat-to-target approaches in clinical practice in UC, and suggests directions for future research. METHODS: We systematically reviewed MEDLINE for studies from the time of the STRIDE systematic review up to March 31, 2018, that assessed the potential treatment targets identified by the STRIDE recommendations. RESULTS: Each potential treatment target literature search returned > 200 articles, which were then reviewed by 2 independent investigators for relevant studies. Selected studies of clinical factors, patient-reported outcomes, endoscopy, histology, imaging, and biomarkers and implications on treatment targets are summarized. CONCLUSIONS: It appears that the relative weight given to different therapeutic targets in the development and improvement of UC treatments could be optimized, with an increased emphasis on endoscopic and histological targets over clinical or symptomatic targets. For this evolution to occur, however, new research has to demonstrate that the treat-to-target approach will deliver on the promise of better long-term outcomes compared with current approaches.

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Section: Resultsmentioning

confidence: 99%

A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review

et al. 2019

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“…CRP became normal first. The mean time was 22 days, which was less than half the time for ESR to become normal (59 days), since CRP correlated with clinical activity while ESR correlated well with endoscopic and histologic colitis [45]. Growing evidence has shown that increased platelets counts seemed to play a crucial role in determining the hypercoagulable state observed in CD [46].…”

Section: Discussionmentioning

confidence: 99%

Oral exclusive enteral nutrition induces mucosal and transmural healing in patients with Crohn’s disease

Chen

Yan

et al. 2019

Gastroenterology Report

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Background and aims Mucosal healing is regarded as a clinical endpoint of Crohn’s disease (CD), and transmural healing is correlated to the concept of deep remission. Current therapies to induce mucosal and transmural healing in CD are not satisfactory. Exclusive enteral nutrition (EEN) is underestimated therapy and its value has not been fully evaluated. Our aim was to investigate the efficacy of oral EEN for inducing mucosal and transmural healing in CD patients. Methods This was a prospective, single-center, open-label study including diagnosed CD children and adults conducted between January 2015 and December 2016 in the Sixth Affiliated Hospital of Sun Yat-sen University. All patients were treated with oral EEN and underwent paired assessment at baseline and completion using C-reaction protein, erythrocyte sedimentation rate, platelets, hemoglobin, body mass index, CD activity index, simple endoscopic score for CD and bowel sonography. Azathioprine was combined to prevent relapse. Results In this prospective observational study, 29 CD patients with an average age of 28.9 years were identified. After oral EEN treatment, 23 patients (79%) achieved complete mucosal healing, and the mean time to reach mucosal healing was 123 days (ranged from 50 to 212 days). Although only five patients (17%) achieved transmural healing, a significant reduction was observed in bowel-wall thickness (9.41 ± 3.06 vs 4.97 ± 1.76 mm, P < 0.001) and a significant improvement was observed in complications (including fistulas, abscess, ascites, stricture) assessed by bowel sonography (all P < 0.05). Conclusions Oral EEN therapy is highly effective for inducing mucosal healing in CD patients. Both CD patients at active stage and those at clinical remission show excellent clinical response to oral EEN.

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“…Inconsistency in the inflammatory markers' response to inflammation and their lack of accuracy have been reported frequently. 63,64 Similar to saccharin, 4-dodecyl benzene sulfonic acid was positively associated with ESR but negatively associated with CRP. It was also positively correlated with calprotectin and the WBC count.…”

Section: Negative-ion Modementioning

confidence: 99%

Metabolomic Signatures in Pediatric Crohn’s Disease Patients with Mild or Quiescent Disease Treated with Partial Enteral Nutrition: A Feasibility Study

Marques¹,

Shokry²,

Frivolt

et al. 2021

SLAS Technology

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Little is known about the metabolic response of pediatric Crohn’s disease (CD) patients to partial enteral nutrition (PEN) therapy and the impact of disease activity and inflammation. We analyzed plasma samples from a nonrandomized controlled intervention study investigating the effect of partial enteral nutrition (PEN) on bone health and growth throughout one year with untargeted metabolomics using high-performance liquid chromatography (HPLC) coupled with high-resolution mass spectrometry (HRMS). Thirty-four paired samples from two time points (baseline and 12 months) were analyzed. Patients (median age: 13.9 years, range: 7–18.9 years, 44% females) were in remission or had mild disease activity. The intervention group received a casein-based formula for 12 months, providing ~25% of estimated daily energy requirements. Sparse partial least squares discriminant analysis (splsda) was applied for group discrimination and identifying sources of variation to identify the impact of PEN. We also investigated the correlation of metabolites with inflammation markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fecal calprotectin. After 12 months, our results show substantial difference between PEN and non-PEN groups in the metabolome of CD patients in remission or with mild disease activity. Inflammatory markers were associated with individual compounds and chemical classes such as isoprenoids and phospholipids. Identified compounds comprise metabolites produced by human or bacterial metabolism, as well as xenobiotics recognized as flavoring agents and environmental contaminants and their biotransformation products. Further longitudinal studies that also include patients with higher disease activity are warranted to evaluate the suitability of these metabolic biomarkers for predicting disease activity.

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Correlation of Erythrocyte Sedimentation Rate and C‐Reactive Protein With Pediatric Inflammatory Bowel Disease Activity

Cited by 41 publications

References 10 publications

A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review

A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review

Oral exclusive enteral nutrition induces mucosal and transmural healing in patients with Crohn’s disease

Metabolomic Signatures in Pediatric Crohn’s Disease Patients with Mild or Quiescent Disease Treated with Partial Enteral Nutrition: A Feasibility Study

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