Development and Validation of the Mucosal Inflammation Noninvasive Index For Pediatric Crohn’s Disease

Cozijnsen, Martinus A.; Shoham, Assaf Ben; Kang, Ben; Choe, Byung‐Ho; Choe, Yon Ho; Jongsma, M; Russell, Richard K.; Ruemmele, Frank M; Escher, Johanna C.; Ridder, Lissy de; Koletzko, Sibylle; Martín-de-Carpi, Javier; Hyams, Jeffrey S.; Walters, Thomas D.; Griffiths, Anne M.; Turner, Dan

doi:10.1016/j.cgh.2019.04.012

Cited by 45 publications

(49 citation statements)

References 29 publications

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“…31 Studies in pediatric patients with CD have shown that adding CRP to FC is better than using FC alone in detecting endoscopic remission. 12,32 However, the AUC curve of CRP was consistently below that of FC in this study, indicating that there was no additional benefit of adding CRP to FC for discriminating those with and without MH on endoscopy.…”

Section: Discussionmentioning

confidence: 59%

Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents

et al. 2022

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Background/Aims: Although mucosal healing (MH) is acknowledged as the treatment target in the treat-to-target era, there are limitations on repeated endoscopic examinations, especially in pediatric patients. We aimed to investigate whether fecal calprotectin (FC) could serve as a surrogate marker for the assessment of MH in pediatric patients with Crohn's disease (CD) who have achieved sustained clinical remission (CR) while treated with anti-tumor necrosis factor (TNF) agents.Methods: This multicenter retrospective cross-sectional study included pediatric CD patients who had sustained a CR for at least 6 months with anti-TNF agents and who simultaneously underwent ileocolonoscopy and FC tests during follow-up. MH was defined as the absence of any ulcer on ileocolonoscopy.Results: A total of 131 patients were included in this study. MH was observed in 87 patients (66.7%). The FC level was significantly lower in patients with MH than in those without MH (median 49.0 mg/kg vs 599.0 mg/kg; p<0.001). According to the multivariate logistic regression analysis, FC was the only factor associated with MH (odds ratio, 0.62; 95% confidence interval [CI], 0.52 to 0.73; p<0.001). According to the receiver operating characteristic curve analysis, the optimal cutoff value for FC for the association with MH was <140 mg/kg (area under the curve 0.890, 95% CI 0.829 to 0.951, sensitivity 78.2%, specificity 88.6%, p<0.001).Conclusions: FC was associated with MH in pediatric patients with CD who had achieved a sustained CR for at least 6 months with anti-TNF agents. In these patients, FC can be used to stratify patients and guide decisions regarding ileocolonoscopy in the treat-to-target era.

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Section: Discussionmentioning

confidence: 59%

Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents

et al. 2022

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“…Scores below six increase the positive predictive value to 86%. The added benefit of MINI over measurement of fecal calprotectin was small but significant, especially for patients with concentrations of fecal calprotectin between 100 and 599 mg/g (45).…”

Section: Mucosal Inflammation Non-invasive Index (Mini) For Pediatric Crohn's Diseasementioning

confidence: 95%

“…Cozijnsen et al (45) aimed to develop and validate a non-invasive index (the Mucosal Inflammation Non-invasive Index -MINI) to assess mucosal inflammation in children with CD. They collected data from the ImageKids study and investigated the association of PCDAI items and laboratory test results with the simple endoscopic score for CD (SESCD).…”

Section: Mucosal Inflammation Non-invasive Index (Mini) For Pediatric Crohn's Diseasementioning

confidence: 99%

An Overview of Tools to Score Severity in Pediatric Inflammatory Bowel Disease

Shaoul

Day

2021

Front. Pediatr.

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Background and Aims: The management of IBD entails the use of various treatments (nutrition, medications, and surgery) in order to induce and maintain remission. The assessment of IBD disease activity is based on a combination of symptoms, clinical findings, imaging, and endoscopic procedures. As in any disease, reliable assessment of disease activity or severity is required in order to plan relevant follow-up, decide on appropriate investigations, determine the best treatment option and subsequently assess response to treatment. It is important for proper documentation, follow-up, assessment of response to treatment and communication, especially in patients with IBD, to talk the same language by using validated and widely used scores for disease activity, endoscopic and radiologic activity, and patient reported outcomes both for clinical practice and research. This review aims to highlight key tools available for the assessment of disease activity or severity in individuals (especially children) with IBD.Methods: A literature search was performed using MEDLINE, Pubmed, and the Cochrane Library with the last search date of August 2020. Tools evaluating disease severity across various aspects (clinical, endoscopic, and radiological) were identified and discussed. Those tools validated and specific for children with IBD were included were available.Results: Over time a number of scoring systems have been developed to quantify clinical, endoscopic and imaging assessments in individuals with IBD. While some are exclusively for children or adults, others appear to have relevance to all age groups. In addition, some tools developed in adult populations are utilized in children, but have not expressly been validated in this age group.Conclusions: Although some available scoring tools are appropriate for children with IBD, others require consideration. The development and use of pediatric-specific tools is relevant and appropriate to optimal care of children and adolescents with IBD.

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“…2 Due to the disadvantages of current means of diagnosing IBD, there is a continued interest in complimentary, non-invasive diagnostic alternatives. These include imaging techniques like computed tomography (CT) or magnetic resonance imaging (MRI) 1,3 and biomarker analyses in feces or serum samples. 4 Creactive protein (CRP) is a widely used serum indicator for IBD in the clinic.…”

Section: Introductionmentioning

confidence: 99%

“…6 However, they do not give any spatial information about the spread of the disease in the GIT and suffer from large interpatient variability. 3 Also, calprotectin is not only a biomarker for IBD but can be associated with e.g. neoplasia, infections, and celiac disease, 4 and is elevated in patients taking nonsteroidal anti-inflammatory drugs.…”

Section: Introductionmentioning

confidence: 99%

Proteomics-Informed Identification of Luminal Targets For In Situ Diagnosis of Inflammatory Bowel Disease

Asad

Wegler

Ahl

et al. 2021

Journal of Pharmaceutical Sciences

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Inflammatory bowel disease (IBD) is a chronic condition resulting in impaired intestinal homeostasis. Current practices for diagnosis of IBD are challenged by invasive, demanding procedures. We hypothesized that proteomics analysis could provide a powerful tool for identifying clinical biomarkers for noninvasive IBD diagnosis. Here, the global intestinal proteomes from commonly used in vitro and in vivo models of IBD were analyzed to identify apical and luminal proteins that can be targeted by orally delivered diagnostic agents. Global proteomics analysis revealed upregulated plasma membrane proteins in intestinal segments of proximal-and distal colon from dextran sulfate sodium-treated mice and also in inflamed human intestinal Caco-2 cells pretreated with pro-inflammatory agents. The upregulated colon proteins in mice were compared to the proteome of the healthy ileum, to ensure targeting of diagnostic agents to the inflamed colon. Promising target proteins for future investigations of non-invasive diagnosis of IBD were found in both systems and included Tgm2/TGM2, Icam1/ICAM1, Ceacam1/CEACAM1, and Anxa1/ANXA1. Ultimately, these findings will guide the selection of appropriate antibodies for surface functionalization of imaging agents aimed to target inflammatory biomarkers in situ.

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Development and Validation of the Mucosal Inflammation Noninvasive Index For Pediatric Crohn’s Disease

Cited by 45 publications

References 29 publications

Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents

Association between Fecal Calprotectin and Mucosal Healing in Pediatric Patients with Crohn’s Disease Who Have Achieved Sustained Clinical Remission with Anti-Tumor Necrosis Factor Agents

An Overview of Tools to Score Severity in Pediatric Inflammatory Bowel Disease

Proteomics-Informed Identification of Luminal Targets For In Situ Diagnosis of Inflammatory Bowel Disease

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