P201 Monitoring histological activity in ulcerative colitis: correlation of faecal biomarkers with the Riley Score and the Nancy Index. (16th January 2018)

• Record Type: Journal Article
• Authors: Langhorst, J; Schroeder, D; Koch, A; Boone, J; Rueffer, A; Juette, H; Tannapfel, A
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S200
• Page End: S200
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.328
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Histological healing in ulcerative colitis (UC) may be a better predictor than macroscopic appearance or clinical criteria for time to relapse. Indicators of acute mucosal inflammation which are used in the Riley Score or the Nancy index are associated with a two- to threefold increase in the risk of UC relapse during 12 months' follow-up. However histologic assessment requires invasive endoscopy and gaining of biopsy. Non-invasive surrogates of mucosal healing would help to lower risks, costs and might increase patient acceptance. Fecal biomarkers are frequently used in UC and might be of help in this endeavour. The study aimed to investigate the performance of non-invasive faecal biomarkers compared with the Riley Score and Nancy index in patients with UC. Methods: Colonoscopy was performed in every patient and a faecal sample was harvested within 72 h. Three biopsies were taken from the macroscopically most inflamed location or random from each colonic segment and Riley Score and Nancy index were calculated. For each patient the highest calculated score was compared with the faecal biomarkers Lactoferrin (LF), Calprotectin (CALPREST - CalP), PMN elastase (PMN-E), S100 calcium-binding protein A12 (S100A12) and Eosinophil-derived Neurotoxin (EDN). It was evaluated if the median levels of the fecal markers differ significantly between the grades 0–4 of the Nancy index. Results: 50 patients (32 female), mean age 42.9 ± 12.3 years (range 23–67) with diagnosed UC were included. The Riley score and the Nancy index correlated with EDN ( r (49) = 0.56; p = .001/ r (49) = 0.45; p = .001), S100A12 ( r (49) = 0.33; p = .022/ r (49) = 0.35; p = .015), PMN-e ( r (49) = 0.31; p = .028/ r (49) = 0.29; p = .044) and LF ( r (49) = 0.45; p = .001/ r (49) = 0.35; p = .015), but not with CalP ( p > .05). The median levels of the faecal markers of the Nancy index and the results of the Kruskal–Wallis test are presented in Table 1. LF, EDN and CalP differed significantly between the grades. Post-hoc tests showed that LF differed significantly between the grades 2 and 3 (z = −3.13, p = .011), EDN between the grades 2 and 4 (z = −3.01, p = .016) and S100A12 between the grades 2 and 3 (z = −3.97, p = .000) and 2 and 4 (z = −3.07, p = .013). Conclusions: The fecal biomarkers LF, EDN, S100A12 and PMN-e were correlated significantly with the Riley and Nancy index, LF, EDN and CalP differed significantly between the grades of the Nancy index. The results support the utility of fecal biomarkers for detecting active histologic inflammation in patients with ulcerative colitis.