eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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4/2016
vol. 11
 
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abstract:
Original paper

Diagnostic importance of faecal markers in long-term monitoring of anti-TNF- therapy in primary responders with Crohn’s disease

Liliana Łykowska-Szuber
,
Katarzyna Klimczak
,
Piotr Eder
,
Iwona Krela-Kaźmierczak
,
Kamila Stawczyk-Eder
,
Michał Michalak
,
Adam Studniarek
,
Tomasz Kościński
,
Aleksandra Szymczak
,
Krzysztof Linke

Gastroenterology Rev 2016; 11 (4): 232–238
DOI: https://doi.org/10.5114/pg.2015.55700
Online publish date: 2015/11/23
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Introduction: Monitoring the response to biological treatment in Crohn’s disease (CD) is a very important element of the therapeutic optimisation.

Aim: To evaluate the usefulness of measuring calprotectin, lactoferrin, and myeloperoxidase in stool as markers of long-term clinical and endoscopic response to anti-tumour necrosis factor α (anti-TNF) treatment in CD.

Material and methods: The studied group consisted of 35 CD patients treated with anti-TNF-α antibodies. Clinical activity was evaluated using Crohn’s Disease Activity Index (CDAI), and the exacerbation of endoscopic changes was evaluated using a Simple Endoscopic Score for Crohn’s Disease (SES-CD). The concentration of calprotectin, lactoferrin, and myeloperoxidase was measured using the ELISA method. All measurements were performed three times – before, after 3 months, and after a year of therapy.

Results: During anti-TNF treatment the concentrations of all measured faecal markers decreased significantly in relation to baseline values. We observed a significant correlation at all time-points: before the therapy, after 3 months, and 12 months after starting the therapy, between the concentration of calprotectin and SES-CD, calprotectin and CDAI, as well as between lactoferrin and SES-CD, and lactoferrin and CDAI. Myeloperoxidase correlated with both SES-CD and CDAI only after 1 year of treatment.

Conclusions: Faecal calprotectin and lactoferrin are valuable markers of clinical and endoscopic activity of CD in patients treated with anti-TNF antibodies. They are useful in monitoring the response to treatment. The usefulness of myeloperoxidase in this respect remains controversial.
keywords:

anti-TNF antibodies, faecal markers, Crohn’s disease
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