PREDICTION OF CROHN’S DISEASE ACTIVITY AND RECURRENCE BY INFLAMMATORY BIOMARKERS IN CLINICALLY REMISSION PATIENTS
Project no. 27 · Status: Kapanmış · 2016
Summary
Inflammatory bowel disease is an inflammatory disease characterized by genetic predisposition, chronic illness, remission and exacerbation periods, whose cause and mechanism are not known precisely. Inflammatory bowel diseases also include important diseases such as Crohn's disease. Crohn's disease is an immunity-based inflammatory disease of unknown etiology that can affect any region of the gastrointestinal tract with transmural involvement. In these patients; many clinical activity indicators and noninvasive markers have been used to assess disease activity, shape the treatment, but none have been as accurate as histopathological and endoscopic examinations in detecting inflammatory activity. Deciding on inflammatory activity is important for approaching the disease and for shaping the treatment. For this reason, an attempt to find an ideal disease suspect has been tried. In Crohn's disease, disease activity is clinically determined by the patient's Crohn's disease activity index (CDAI) score. According to this, while it is accepted as a disease with less than 150 points remission, it is regarded as a serious fulminant disease over 450 points. In this study, in clinical remission of Crohn's disease, disease activity was aimed to be predicted by biochemical markers before the onset of clinical symptoms and to find an ideal locator. Twelve asymptomatic patients with Crohn's disease (CDAI <150) were included in our study, who were referred to Ege University Medical Faculty, the Department of Internal Medicine, Gastroenterology policlinics; and CDAI score was calculated on the day when all patients applied. C reactive protein (CRP), serum amyloid A (SAA), erytrocyte sedimentation rate, and complete blood count were measured in blood samples, and fecal calprotectin, lactoferrin in the gut samples. Colonoscopy revealed that 5 patients were in remission and 7 patients were active. Between active patients and patients in remission; statistically significant difference was found for fecal calprotectin, lactoferrin, serum CRP and SAA (p <0.050 for all). Fecal calprotectin and/or lactoferrin tests which reflect mucosal inflammation well should be performed before a troublesome and invasive test such as colonoscopy. Itis shown that patients who will undergo colonoscopy can be better selected. Comprehensive studies in larger groups of CH in the light of the relevant literature will increase the power of these biomarkers in diagnosis and follow-up.