scholarly journals Fecal Lactoferrin and Other Putative Fecal Biomarkers in Crohn’s Disease: Do They Still Have a Potential Clinical Role?

Digestion ◽  
2021 ◽  
pp. 1-12
Author(s):  
Filippo Vernia ◽  
Angelo Viscido ◽  
Mirko Di Ruscio ◽  
Gianpiero Stefanelli ◽  
Marco Valvano ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Capsule Endoscopy ◽  
Postoperative Recurrence ◽  
Response To Therapy ◽  
Polymorphonuclear Neutrophil ◽  
Fecal Lactoferrin ◽  
Fecal Markers ◽  
Fecal Biomarkers

<b><i>Introduction:</i></b> The need for noninvasive markers of disease activity is mandatory in the assessment of Crohn’s disease (CD). The most widely fecal biomarker in CD, despite several limits, is fecal calprotectin. This review aims to elucidate the role, if any, of all other fecal biomarkers, as alternative tools for assessing clinical and endoscopic disease activity, and predict capsule endoscopy findings, response to therapy, disease relapse, and postoperative recurrence. These fecal biomarkers included lactoferrin, S100A12, high mobility group box 1, neopterin, polymorphonuclear neutrophil elastase, fecal hemoglobin, alpha1-antitrypsin, lysozyme, human beta-defensin-2, neutrophil gelatinase-associated lipocalin, matrix metalloproteinase-9, chitinase 3-like-1, M2-pyruvate kinase, myeloperoxidase, and eosinophil proteins. <b><i>Methods:</i></b> A systematic electronic search in the medical literature was performed up to April 2020. Seventy eligible studies were identified out of 859 citations. Data were grouped according to the assessment of clinical and endoscopic disease activity, capsule endoscopy findings, response to therapy, prediction of relapse, and postoperative recurrence. <b><i>Results:</i></b> The overall correlation between lactoferrin and clinical indexes is poor, while performance is good with endoscopic scores. Lactoferrin seems to represent a reasonably good surrogate marker of response to therapy and to be potentially useful in identifying patients at high risk for endoscopic relapse or postoperative recurrence. The evaluation of the performance of all other fecal markers is limited by the lack of adequate data. <b><i>Conclusions:</i></b> None of the fecal markers so far represents an acceptable alternative to calprotectin in clinical practice. Fecal lactoferrin is the only possible exception, but a more extensive investigation is still required.

scholarly journals Validation of Capsule Endoscopy Crohn's Disease Activity Score (CECDAI or Niv Score) – A Multi Center Prospective Study

2011 ◽  
Vol 140 (5) ◽  
pp. S-768
Author(s):  
Yaron Niv ◽  
Sagi Ilani ◽  
Zohar Levi ◽  
Marcella Hershkowitz ◽  
Colm A. O'Morain ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Prospective Study ◽  
Disease Activity ◽  
Capsule Endoscopy ◽  
Disease Activity Score ◽  
Activity Score ◽  
Crohn’S Disease Activity

scholarly journals P492 Use of bowel ultrasound to assess disease activity in Crohn’s disease patients after induction therapy with infliximab

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S431-S431
Author(s):  
C Frias Gomes ◽  
C Neto Nascimento ◽  
F Pereira ◽  
A Caldeira ◽  
R Sousa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Induction Therapy ◽  
Patient Management ◽  
Daily Practice ◽  
Response To Therapy ◽  
Rapid Improvement ◽  
Faecal Calprotectin ◽  
Bowel Ultrasound

Abstract Background Objective goals are needed to guide patient management and assess treatment efficacy in patients with Crohn’s disease (CD). Bowel ultrasound (US) is a widely available, non-invasive and inexpensive technique increasingly being used in these patients. The use of bowel wall thickness (BWT) has been proved to be an accurate measure for assessing disease activity and response to therapy. Recent studies show a rapid improvement of BWT after 3-month of therapy. Our aim was to evaluate BWT variation after induction therapy with infliximab (IFX) in CD patients and correlate BWT with clinical and laboratory parameters. Methods Prospective cohort multicentre study including patients with active CD starting IFX therapy. Clinical disease activity was assessed using the Harvey–Bradshaw index (HBI). C-reactive protein (CRP) and faecal calprotectin (FC) were measured both at week 0 and after induction therapy (week 14), and infliximab trough levels (ITL) were measured at week 14. Bowel ultrasound was performed at week 0 and 14, BWT from the worst segment was selected for analysis. Abnormal BWT was defined has higher than 3mm in any bowel segment. Results We included 10 patients with CD (80% males; median age 29 (21–64) years). According to Montreal classification, most patients were A2 (7/10), had ileocolonic disease (L1 20%; L2 20%; L3 60%) and an inflammatory phenotype (B1 60%; B2 20% and B3 20%). Most patients were anti-TNF therapy naive (80%), and combination therapy was used in 80%. Before IFX (week 0) median HBI was 2 (IQR 1.75–5.25), CRP 1.10 mg/dl (IQR 0.65–3.50) and FC 802 μg/g (IQR 324–1336). The terminal ileum was the most affected segment identified by the USA (5/10), followed by ascending colon (2/10) descending colon (2/10) and sigmoid colon (1/10). Median BWT was 4.6 mm (IQR 3.6–6.4). After induction therapy (week 14), all patients were in clinical remission (HBI&lt;5) except for one in whom IFX dose was increased to 10 mg/kg. Laboratory remission (CRP &lt; 0.5 mg/dl and FC &lt; 250 μg/g) was present in 50% of patients. US response (measured by a reduction in BWT of at least 0.5 mm) was observed in 70% of patients, with US remission (normalisation of BWT in the most affected segment) in 30%. At week 14, 70% of patient had ITL &gt; 3 μg/ml. Median BWT at week 14 was higher in patients with ITL &lt; 3 μg/ml (6.25 vs. 2.98 mm, p = 0.048). Conclusion The majority of our patients showed a US response (reduction in BWT) after 14 weeks of infliximab, suggesting that reduction in BWT could be an early marker of response to therapy. US evaluation after induction therapy can be a helpful tool to monitor disease activity and guide patient management in CD patients in our daily practice.

Relationships Between Disease Activity and Serum and Fecal Biomarkers in Patients With Crohn's Disease

2008 ◽  
Vol 6 (11) ◽  
pp. 1218-1224 ◽  
Author(s):  
Jennifer Jones ◽  
Edward V. Loftus ◽  
Remo Panaccione ◽  
Li–Sheng Chen ◽  
Sandra Peterson ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Fecal Biomarkers

scholarly journals The Role of MR Enterography in Assessing Crohn’s Disease Activity and Treatment Response

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Matthew P. Moy ◽  
Jenny Sauk ◽  
Michael S. Gee
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Treatment Response ◽  
Imaging Modality ◽  
The United States ◽  
Response To Therapy ◽  
Mr Enterography ◽  
Oral Contrast

MR enterography (MRE) has become the primary imaging modality in the assessment of Crohn’s disease (CD) in both children and adults at many institutions in the United States and worldwide, primarily due to its noninvasiveness, superior soft tissue contrast, and lack of ionizing radiation. MRE technique includes distention of the small bowel with oral contrast media with the acquisition of T2-weighted, balanced steady-state free precession, and multiphase T1-weighted fat suppressed gadolinium contrast-enhanced sequences. With the introduction of molecule-targeted biologic agents into the clinical setting for CD and their potential to reverse the inflammatory process, MRE is increasingly utilized to evaluate disease activity and response to therapy as an imaging complement to clinical indices or optical endoscopy. New and emerging MRE techniques, such as diffusion-weighted imaging (DWI), magnetization transfer, ultrasmall superparamagnetic iron oxide- (USPIO-) enhanced MRI, and PET-MR, offer the potential for an expanded role of MRI in detecting occult disease activity, evaluating early treatment response/resistance, and differentiating inflammatory from fibrotic strictures. Familiarity with MR enterography is essential for radiologists and gastroenterologists as the technique evolves and is further incorporated into the clinical management of CD.

The diagnostic usefulness of fecal lactoferrin in the assessment of Crohn's disease activity

2015 ◽  
Vol 26 (8) ◽  
pp. 623-627 ◽  
Author(s):  
Katarzyna Klimczak ◽  
Liliana Lykowska-Szuber ◽  
Piotr Eder ◽  
Iwona Krela-Kazmierczak ◽  
Kamila Stawczyk-Eder ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Fecal Lactoferrin ◽  
Diagnostic Usefulness ◽  
Crohn’S Disease Activity
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