Serum Biomarkers May Help Predict Crohn’s Disease
A series of studies published in Gastroenterology provided a deeper look at predictive tools and prevention methods in patients with Crohn’s disease.
In the first study, researchers examined serum sample from patients before Crohn’s disease (n = 200) was diagnosed. Samples from 200 healthy individuals acted as a control group.
The researchers identified 51 protein biomarkers that were predictive of developing Crohn´s disease within 5 years of diagnosis with approximately 75% accuracy. The development of CD was associated with changes in the complement cascade, lysosomes, innate immune response, and glycosaminoglycan metabolism.
In the second study, CALM study follow-up data from 122 patients (mean age, 31.2±11.3 year) with early, moderate to severe CD (median duration 0.2 year; interquartile range, 0.1–0.5 year) was analyzed.
Patients were randomly assigned to a tight control strategy (increased therapy based on fecal level of calprotectin, serum level of C-reactive protein, and symptoms) (n = 61) or conventional management (n = 61). At the end of the follow-up period (median 3.02 year; range, 0.05–6.26 year) patients were categorized by whether they were in deep remission or not.
During the follow-up period, major adverse outcomes were reported in 34 patients (27.9%). There were significantly fewer patients in deep remission at the end of the CALM study had major adverse outcomes during the follow-up period (P = 0.01).
The authors concluded that deep remission deep remission (adjusted hazard ratio, 0.19; 95% CI, 0.07–0.31) was significantly associated with a lower risk of major adverse outcome.
Torres J, Petralia F, Sato T, et al. Serum biomarkers identify patients who will develop inflammatory bowel diseases up to 5 y before diagnosis. Gastroenterology. 2020; DOI: https://doi.org/10.1053/j.gastro.2020.03.007
Ungaro RC, Yzet C, Bossuyt P, et al. Deep remission at 1 year prevents progression of early crohn’s disease. Gastroenterology. 2020; DOI: https://doi.org/10.1053/j.gastro.2020.03.039