Disease Activity Assessment in IBD

Falvey, James D.; Hoskin, Teagan; Meijer, Berrie; Ashcroft, Anna; Walmsley, Russell; Day, Andrew S.; Gearry, Richard B.

doi:10.1097/mib.0000000000000341

Cited by 126 publications

(53 citation statements)

References 33 publications

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“…This appears to be a more clinically relevant comparison as the goal of IBD therapy is mucosal healing, which in turn is associated with durable remission and decreased risk of surgery [27]. Consistent with previous work [14, 15, 25], in our study, SIBDQ and HBI correlated poorly with endoscopic disease activity in CD. When examining the relationship between SIBDQ and endoscopic disease activity, Casellas et al [25] reported a correlation of −0.31, similar to the −0.17 in this study.…”

Section: Discussionsupporting

confidence: 89%

Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Taleban

Stewart

et al. 2016

Dig Dis Sci

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Background Clinical activity and quality of life (QOL) indices assess disease activity in Crohn’s disease (CD) and ulcerative colitis (UC). However, a paucity of data exists on the validity of these indices according to disease characteristics. Aims To examine the correlation between QOL and clinical activity indices and endoscopic disease activity according to disease characteristics. Methods We used a prospective registry to identify CD and UC patients ≥18 years old with available information on Short Inflammatory Bowel Disease Questionnaire scores (SIBDQ), Harvey–Bradshaw Index (HBI) and simple endoscopic scores for CD (SES-CD), and Simple Clinical Colitis Activity Index (SCCAI) and Mayo endoscopic score for UC. We used Spearman rank correlations to calculate correlations between indices and Fisher transformation to compare correlations across disease characteristics. Results Among 282 CD patients, we observed poor correlation between clinical activity and QOL indices to SES-CD with no differences in correlation according to disease characteristics. Conversely, among 226 UC patients, clinical activity and QOL had good correlation to Mayo endoscopic score (r = 0.55 and −0.56, respectively) with better correlations observed with left-sided versus extensive colitis (r = 0.73 vs. 0.45, p = 0.005) and shorter duration of disease (r = 0.61 vs. 0.37, p = 0.04). Conclusions Our data suggest good correlation between SCCAI and endoscopic disease activity in UC, particularly in left-sided disease. Poor correlations between HBI or SIBDQ and SES-CD appear to be consistent across different disease phenotypes.

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Section: Discussionsupporting

confidence: 89%

Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Taleban

Stewart

et al. 2016

Dig Dis Sci

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“…Periodic monitoring is also necessary to avoid persistent chronic inflammation that can cause colorectal cancer. In addition to serum CRP, recent reports showed that faecal calprotectin was an effective biomarker for mucosal healing; 27 however, faecal samples have inherent associated problems such as limited quantitative capability and cumbersome sampling, which are not significant concerns for serum samples. Accurate detection of mucosal inflammation by a serum biomarker will facilitate the avoidance of frequent endoscopic procedures in patients.…”

Section: Discussionmentioning

confidence: 99%

Leucine-rich Alpha-2 Glycoprotein is a Serum Biomarker of Mucosal Healing in Ulcerative Colitis

Shinzaki

Matsuoka

Iijima

et al. 2016

Journal of Crohn's and Colitis

115

103

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Background and Aims:Although several noninvasive and easily accessible biomarkers for inflammatory bowel disease [IBD] are available, their sensitivity and specificity are not adequate to be used as single markers and do not overrule the need for endoscopic evaluation. We previously reported that serum leucine-rich alpha-2 glycoprotein [LRG] was a novel biomarker for rheumatoid arthritis and IBD. We herein investigated whether LRG could indicate endoscopic activity in patients with ulcerative colitis [UC].Methods:Serum LRG concentrations were determined by enzyme-linked immunosorbent assay [ELISA] in consecutive 129 patients with UC in two tertiary care hospitals, and associations of LRG with clinical and endoscopic activities were evaluated. Clinical activity index [CAI] < 6 was defined as clinical remission, and mucosal healing [MH] and complete mucosal healing were defined as Matts’ endoscopic grades of 1 or 2 and grade of 1, respectively.Results:Serum LRG levels were significantly increased and correlated with clinical and endoscopic activities in patients with UC. LRG levels were associated with both clinical and endoscopic activities even in patients with normal serum C-reactive protein [CRP] levels. Furthermore, LRG levels were significantly lower in patients with complete MH and deep remission. Serial measurements of LRG levels in a subset of patients demonstrated that LRG was significantly elevated during the endoscopically active stage compared with that during the MH stage.Conclusions:Serum LRG is a novel biomarker for detecting MH during disease course in patients with UC and a surrogate marker of endoscopic inflammation in patients with normal CRP levels.

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“…The current diagnosis and management of IBD is based on clinical and endoscopic criteria [ 29 ]. More specifically, as routine clinical assessment is often inaccurate with respect to endoscopic activity [ 30 ], colonoscopy represents the gold standard technique for the evaluation of disease severity. However, due to the complexity and invasiveness of this practice, there is a pressing need for new non-invasive biomarkers to improve disease activity detection, in order to better determine prognosis and to monitor drug response.…”

Section: Resultsmentioning

confidence: 99%

Linking estrogen receptor β expression with inflammatory bowel disease activity

et al. 2015

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Crohn disease (CD) and ulcerative colitis (UC) are chronic forms of inflammatory bowel disease (IBD) whose pathogenesis is only poorly understood. Estrogens have a complex role in inflammation and growing evidence suggests that these hormones may impact IBD pathogenesis. Here, we demonstrated a significant reduction (p < 0.05) of estrogen receptor (ER)β expression in peripheral blood T lymphocytes from CD/UC patients with active disease (n = 27) as compared to those in remission (n = 21) and healthy controls (n = 29). Accordingly, in a subgroup of CD/UC patients undergoing to anti-TNF-α therapy and responsive to treatment, ERβ expression was higher (p < 0.01) than that observed in not responsive patients and comparable to that of control subjects. Notably, ERβ expression was markedly decreased in colonic mucosa of CD/UC patients with active disease, reflecting the alterations observed in peripheral blood T cells. ERβ expression inversely correlated with interleukin (IL)-6 serum levels and exogenous exposure of both T lymphocytes and intestinal epithelial cells to this cytokine resulted in ERβ downregulation. These results demonstrate that the ER profile is altered in active IBD patients at both mucosal and systemic levels, at least in part due to IL-6 dysregulation, and highlight the potential exploitation of T cell-associated ERβ as a biomarker of endoscopic disease activity.

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Disease Activity Assessment in IBD

Abstract: C-reactive protein and fecal calprotectin are useful for the identification of endoscopically active IBD, but normal results do not confirm endoscopic remission.

Cited by 126 publications

References 33 publications

Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Leucine-rich Alpha-2 Glycoprotein is a Serum Biomarker of Mucosal Healing in Ulcerative Colitis

Linking estrogen receptor β expression with inflammatory bowel disease activity

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