Researchers determined that shortcomings in current methods to analyze inflammatory bowel disease (IBD) and the potential for inaccurate conclusions regarding extent of inflammation in Crohn’s disease (CD) and ulcerative colitis (UC) can be overcome by using several biomarker mechanisms simultaneously.
Researchers wrote; "This exploratory biomarker study identified combinations of biomarkers including fecal calprotectin, serum MMP9 and serum IL-22 that were correlated with objective measures of disease activity. In addition, this study highlights the importance of cross-sectional imaging in compensating for the shortcomings of ICO [ileocolonoscopy] in accurately quantifying disease burden in patients with CD [Crohn’s disease].”
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For the study, 107 ulcerative colitis (UC) and 157 CD patients underwent ICO, after which 66 CD patients underwent computed tomography enterography (CTE), and a combined ICO-CTE score was determined.
Researchers then analyzed serum and fecal biomarkers for association with ICO or ICO-CTE in CD patients and Mayo Clinic endoscopy scores in UC patients. Biomarkers demonstrating moderate correlation were further studied with multivariate analysis.
The analysis determined the combination of fecal calprotectin and serum matrix metalloproteinase 9 demonstrated the strongest association with UC inflammation as determined by imaging and/or endoscopy.
For Crohns Disease patients, researchers determined the use of combined ICO and CTE increased biomarker performance, and a combination of fecal calprotectin, serum MMP9 and serum interleukin-22 resulted in the strongest association as seen in imaging and/or endoscopy.
Researchers concluded; “These biomarker combinations will need to be prospectively validated to establish optimal cutoffs and determine their potential role in the care of patients. However, this study holds the promise that understanding the function of identified biomarkers in tissue injury, remodeling and repair, may provide new insights into the pathogenic mechanisms common to both Crohns Disease and Ulcerative Colitis.”