Serum Neutrophil Biomarkers to Predict Crohn's Disease Progression and Infliximab Treatment Outcomes

被引:0
|
作者
Magalhaes, D. [1 ]
Santiago, M. [2 ,3 ]
Patita, M. [4 ]
Arroja, B. [5 ]
Lago, P. [6 ]
Rosa, I. [7 ]
Sousa, H. T. [8 ,9 ]
Ministro, P. [10 ]
Mocanu, I. [4 ]
Vieira, A. [4 ]
Castela, J. [7 ]
Moleiro, J. [7 ]
Roseira, J. [8 ,9 ]
Eugenia, C. [10 ]
Sousa, P. [10 ]
Portela, F. [11 ]
Correia, L. [12 ]
Dias, S. [3 ]
Afonso, J. [1 ]
Danese, S. [13 ,14 ]
Peyrin-Biroulet, L. [15 ,16 ]
Dias, C. C. [17 ,18 ]
Magro, F. [1 ,2 ,3 ,19 ,20 ]
GED, II
机构
[1] Univ Porto, Fac Med, Dept Biomed, Unit Pharmacol & Therapeut, Porto, Portugal
[2] CINTESIS, Ctr Hlth Technol & Serv Res, Porto, Portugal
[3] GEDII, Portuguese Inflammatory Bowel Dis Grp, Porto, Portugal
[4] Garcia Orta Hosp, Dept Gastroenterol, Almada, Portugal
[5] Braga Hosp, Dept Gastroenterol, Braga, Portugal
[6] Porto Hosp Univ Ctr, Dept Gastroenterol, Porto, Portugal
[7] IPOLFG, Dept Gastroenterol, EPE, Lisbon, Portugal
[8] Unidade Local Saude Algarve, Dept Gastroenterol, Portimao, Portugal
[9] Univ Algarve, ABC Algarve Biomed Ctr, Faro, Portugal
[10] Tondela Viseu Hosp Ctr, Dept Gastroenterol, Viseu, Portugal
[11] Coimbra Univ Hosp Ctr, Gastroenterol Dept, Coimbra, Portugal
[12] Northern Lisbon Univ Hosp Ctr, Gastroenterol Dept, Lisbon, Portugal
[13] Humanitas Univ, Dept Biomed Sci, Milan, Italy
[14] Humanitas Res Hosp, IBD Ctr, IRCCS, Milan, Italy
[15] Univ Lorraine, Univ Hosp Nancy, Dept Gastroenterol, Nancy, France
[16] Univ Lorraine, Univ Hosp Nancy, Inserm NGERE U1256, Nancy, France
[17] Univ Porto FMUP, Dept Community Med Informat & Hlth Decis Sci MEDCI, CINTESISRISE, Informat & Hlth Decis Sci MEDCIDS,Fac Med, Porto, Portugal
[18] Univ Porto FMUP, Knowledge Management Unit, Fac Med, Porto, Portugal
[19] Sao Joao Hosp Univ Ctr, Dept Gastroenterol, Porto, Portugal
[20] Sao Joao Hosp Univ Ctr, Unit Clin Pharmacol, Porto, Portugal
关键词
Crohn's disease; fecal calprotectin; infliximab; lactoferrin'; lipocalin-2; neutrophil elastase; resistin; serum neutrophil biomarkers; GELATINASE-ASSOCIATED LIPOCALIN; ULCERATIVE-COLITIS; TNF-ALPHA; INFLAMMATION; ELASTASE; TOOLS;
D O I
10.1002/ueg2.12712
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and aims: Predicting the treatment outcomes of biological therapies is an unmet need in Crohn's Disease. In this study, we explored the potential of serum neutrophil-related biomarkers to predict infliximab therapeutic results and disease progression in Crohn's Disease patients, over a 2-year period, in a real-world setting. Methods: The study included 100 asymptomatic Crohn's Disease patients in the IFX maintenance phase from the prospective, observational, multicenter DIRECT study. Patients were categorized according to a composite outcome reflecting progression that included surgery, hospitalizations, new fistulae, abscess or stricture, and drug treatment escalation. Serum neutrophil elastase, lipocalin-2, lactoferrin, and resistin (non-neutrophil control) were analyzed via multiplex magnetic bead assays at multiple touchpoints. Fecal calprotectin was assessed by ELISA. Results: Over up to 2 years of follow-up, serum biomarkers did not differentiate between the composite outcome groups, whereas fecal calprotectin was significantly higher in patients with worse outcomes. During the infliximab maintenance phase, there was a significant, sustained reduction of neutrophil elastase (p < 0.001), lipocalin-2 (p < 0.001), and lactoferrin (p < 0.001), but not of resistin, despite stable neutrophil levels. Correlations between NE and NGAL levels were strong (Pearson correlations 0.75-0.85); all other correlations were of small magnitude. Conclusion: Our real-world data do not support using serum neutrophil elastase, lipocalin-2, or lactoferrin concentrations as predictors of treatment outcomes or disease evolution in infliximab -treated Crohn's Disease patients. On the other hand, the sustained decrease in biomarkers over time suggests that neutrophil stabilization might be an additional infliximab mechanism of action.
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页码:229 / 239
页数:11
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