Faecal biomarkers for diagnosis and prediction of disease course in treatment-naïve patients with IBD.

Autor: Ling Lundström M; Department of Medical Sciences, Gastroenterology Research Group, Uppsala University, Uppsala, Sweden., Peterson C; Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden., Hedin CRH; Karolinska Institute, Department of Medicine Solna, Stockholm, Sweden.; Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden., Bergemalm D; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Lampinen M; Department of Pharmacy, Uppsala University, Uppsala, Sweden., Magnusson MK; Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden., Keita ÅV; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden., Kruse R; Department of Clinical Research Laboratory, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Lindqvist CM; Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden., Repsilber D; Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden., D'Amato M; Gastrointestinal Genetics Lab, CIC BioGUNE-BRTA, Derio, Spain.; Ikerbasque, Basque Foundation for Science, Bilbao, Spain., Hjortswang H; Department of Health, Medicine, and Caring Sciences, Linköping University, Linkoping, Sweden., Strid H; Gastroenterology Unit, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden., Söderholm JD; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.; Department of Surgery, Linköping University, Linköping, Sweden., Öhman L; Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden., Venge P; Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden., Halfvarson J; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Carlson M; Department of Medical Sciences, Gastroenterology Research Group, Uppsala University, Uppsala, Sweden.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2024 Sep; Vol. 60 (6), pp. 765-777. Date of Electronic Publication: 2024 Jul 12.
DOI: 10.1111/apt.18154
Abstrakt: Background: Faecal biomarkers can be used to assess inflammatory bowel disease (IBD).
Aim: To explore the performance of some promising biomarkers in diagnosing and predicting disease course in IBD.
Methods: We included 65 patients with treatment-naïve, new-onset Crohn's disease (CD), 90 with ulcerative colitis (UC), 67 symptomatic controls (SC) and 41 healthy controls (HC) in this prospective observational study. We analysed faecal samples for calprotectin (FC), myeloperoxidase (MPO), human neutrophil lipocalin (HNL), eosinophil cationic protein ECP and eosinophil-derived neurotoxin (EDN) and compared markers among groups. We assessed the diagnostic capability of biomarkers with receiver operating characteristic curves. Clinical disease course was determined for each patient with IBD and analysed the association with biomarkers by logistic regression.
Results: All markers were elevated at inclusion in patients with IBD compared with HC (p < 0.001) and SC (p < 0.001). FC (AUC 0.85, 95% CI: 0.79-0.89) and MPO (AUC 0.85, 95% CI: 0.80-0.89) showed the highest diagnostic accuracy in distinguishing IBD from SC. The diagnostic ability of biomarkers differed between IBD subtypes with the highest performance for FC and MPO in CD. The diagnostic accuracy was further improved by combining FC and MPO (p = 0.02). Levels of FC, MPO and HNL at inclusion were predictive of an aggressive disease course with MPO showing the strongest association (p = 0.006).
Conclusions: This study provides new insight into the diagnostic and prognostic capability of neutrophil and eosinophil biomarkers in IBD and suggests that MPO, alone or in combination with FC, may add to the diagnostic power of faecal biomarkers.
(© 2024 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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